PMID- 33971674
OWN - NLM
STAT- MEDLINE
DCOM- 20210811
LR  - 20220425
IS  - 1438-8790 (Electronic)
IS  - 0934-8387 (Linking)
VI  - 75
IP  - 8
DP  - 2021 Aug
TI  - [Frequency Distribution and Risk Factors for Latent Tuberculosis in Contact 
      Persons: Cologne 2012-2016].
PG  - 567-576
LID - 10.1055/a-1479-0168 [doi]
AB  - BACKGROUND:  As part of tuberculosis control and the WHO end-TB strategy, contact 
      persons of tuberculosis patients in Germany are examined for a possible infection 
      with latent tuberculosis (LTBI). Activation of LTBI contributes a considerable 
      proportion of newly reported tuberculosis cases in low-incidence countries such 
      as Germany. Therefore, the aim is to detect cases of LTBI and, through 
      chemopreventive treatment of these cases, prevent future, post-primary, active 
      tuberculosis.In Germany, the rate of LTBI among contact persons of people 
      diagnosed with active tuberculosis is not systematically recorded. The aim of the 
      present work was to close this data gap for Cologne, a major city in Germany with 
      a TB incidence of around 9/100,000 in the past years. The study further aimed to 
      describe risk factors for LTBI and to reevaluate the standard inclusion criteria 
      for contact investigation for tuberculosis under routine conditions in Germany. 
      MATERIAL AND METHODS:  For the period 07/2012 to 12/2016, the retrospective 
      cohort study examined the rate of LTBI diagnoses among contact persons of those 
      with pulmonary tuberculosis notified at the Cologne public health department, as 
      well as factors that increase the LTBI infection risk of contact persons. The 
      diagnosis of latent tuberculosis was made when the interferon-gamma release assay 
      (IGRA) was positive and there were no signs of active tuberculosis. The study 
      included contact persons who cumulatively had a previously defined minimum total 
      contact time with a tuberculosis patient, who were at least 5 years old at the 
      time of the study and who were registered in Cologne. Statistical evaluation was 
      carried out descriptively as absolute and relative frequency with a significance 
      level of p </= 0.05. The analytical evaluation was carried out with univariate and 
      multivariate logistic regression. RESULTS:  Of a total of 3862 IGRA examinations 
      among contact persons, 2834 cases met the inclusion criteria. A median of seven 
      contact persons per index patient was reported. 12.5 % ​​of the study group 
      tested positive for LTBI. In contact persons of microscopically open index 
      patients, the positivity rate was 11.4 %, in culturally open but microscopically 
      negative index patients, it was 14.3 %. Factors associated with a higher risk of 
      LTBI included male sex (OR = 1.95), age >/= 50 years (OR = 1.8) and household 
      exposure (OR = 2.37). CONCLUSION:  Using the German standard criteria, the 
      positivity rate of IGRA testing and the diagnosis of LTBI among contacts in the 
      present study was 12.5 %, which is lower than in other similar studies. Factors 
      identified in the cohort for an increased risk of LTBI confirm known 
      constellations. The significantly higher positivity rate among contact persons of 
      microscopically negative but culturally positive index patients (p = 0.033) 
      underscores the need to conduct a detailed contact examination of individuals of 
      this group as well.
CI  - Thieme. All rights reserved.
FAU - Dwenger, L V
AU  - Dwenger LV
AD  - Gesundheitsamt der Stadt Koln, Abteilung Infektions- und Umwelthygiene, 
      Tuberkulose-Beratungsstelle.
AD  - Institut fur Arbeits-, Sozial- und Umweltmedizin, Universitatsklinik, RWTH 
      Aachen.
FAU - Funke, N
AU  - Funke N
AD  - Gesundheitsamt der Stadt Koln, Abteilung Infektions- und Umwelthygiene, 
      Tuberkulose-Beratungsstelle.
FAU - Stephany, P
AU  - Stephany P
AD  - Gesundheitsamt der Stadt Koln, Abteilung Infektions- und Umwelthygiene, 
      Tuberkulose-Beratungsstelle.
FAU - Suarez, I
AU  - Suarez I
AD  - Medizinische Klinik 1, Infektionsambulanz, Universitatsklinikum Koln.
FAU - Wiesmuller, G A
AU  - Wiesmuller GA
AD  - Gesundheitsamt der Stadt Koln, Abteilung Infektions- und Umwelthygiene, 
      Tuberkulose-Beratungsstelle.
AD  - Institut fur Arbeits-, Sozial- und Umweltmedizin, Universitatsklinik, RWTH 
      Aachen.
FAU - Neuhann, F
AU  - Neuhann F
AD  - Gesundheitsamt der Stadt Koln, Abteilung Infektions- und Umwelthygiene, 
      Tuberkulose-Beratungsstelle.
AD  - Heidelberger Institut fur Global Health, Universitatsklinikum Heidelberg.
AD  - School of Medicine and Clinical Sciences, Levy Mwanawasa Medical University, 
      Lusaka, Zambia.
LA  - ger
PT  - Journal Article
TT  - Latente Tuberkulose unter Kontaktpersonen inzidenter Tuberkulosepatienten: 
      Haufigkeit und Risikofaktoren in Koln 2012-2016.
DEP - 20210510
PL  - Germany
TA  - Pneumologie
JT  - Pneumologie (Stuttgart, Germany)
JID - 8906641
SB  - IM
MH  - Child, Preschool
MH  - Humans
MH  - Interferon-gamma Release Tests
MH  - *Latent Tuberculosis/diagnosis/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Tuberculosis/diagnosis/epidemiology
COIS- Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.
EDAT- 2021/05/11 06:00
MHDA- 2021/08/12 06:00
CRDT- 2021/05/10 20:31
PHST- 2021/05/11 06:00 [pubmed]
PHST- 2021/08/12 06:00 [medline]
PHST- 2021/05/10 20:31 [entrez]
AID - 10.1055/a-1479-0168 [doi]
PST - ppublish
SO  - Pneumologie. 2021 Aug;75(8):567-576. doi: 10.1055/a-1479-0168. Epub 2021 May 10.