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Passive Versus Active Tuberculosis Case Finding and Isoniazid Preventive Therapy Among Household Contacts in a Rural District of Malawi.

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dc.contributor Operational Research (HIV/TB), Medical Department, Médecins sans Frontières-Brussels Operational Centre, Brussels, Belgium. zachariah@internet.lu
dc.creator Zachariah, R
dc.creator Spielmann M P
dc.creator Harries, A D
dc.creator Gomani, P
dc.creator Graham, S
dc.creator Bakali, E
dc.creator Humblet, P
dc.date 2003-11
dc.date.accessioned 2017-01-31T07:09:37Z
dc.date.available 2017-01-31T07:09:37Z
dc.identifier Passive Versus Active Tuberculosis Case Finding and Isoniazid Preventive Therapy Among Household Contacts in a Rural District of Malawi. 2003, 7 (11):1033-9 Int. J. Tuberc. Lung Dis.
dc.identifier 1027-3719
dc.identifier 14598961
dc.identifier http://hdl.handle.net/10144/17741
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/17741
dc.identifier International Journal of Tuberculosis and Lung Disease
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/17741
dc.description SETTING: Thyolo district, rural Malawi. OBJECTIVES: To compare passive with active case finding among household contacts of smear-positive pulmonary tuberculosis (TB) patients for 1) TB case detection and 2) the proportion of child contacts aged under 6 years who are placed on isoniazid (INH) preventive therapy. DESIGN: Cross-sectional study. METHODS: Passive and active case finding was conducted among household contacts, and the uptake of INH preventive therapy in children was assessed. RESULTS: There were 189 index TB cases and 985 household contacts. Human immunodeficiency virus (HIV) prevalence among index cases was 69%. Prevalence of TB by passive case finding among 524 household contacts was 0.19% (191/100000), which was significantly lower than with active finding among 461 contacts (1.74%, 1735/100000, P = 0.01). Of 126 children in the passive cohort, 22 (17%) received INH, while in the active cohort 25 (22%) of 113 children received the drug. Transport costs associated with chest X-ray (CXR) screening were the major reason for low INH uptake. CONCLUSIONS: Where the majority of TB patients are HIV-positive, active case finding among household contacts yields nine times more TB cases and is an opportunity for reducing TB morbidity and mortality. The need for a CXR is an obstacle to the uptake of INH prophylaxis.
dc.language en
dc.publisher International Union Against TB and Lung Disease
dc.relation http://www.ingentaconnect.com/content/iuatld/ijtld
dc.rights Archived on this site with the kind permission of the International Union Against TB and Lung Disease, http://www.iuatld.org
dc.title Passive Versus Active Tuberculosis Case Finding and Isoniazid Preventive Therapy Among Household Contacts in a Rural District of Malawi.


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