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BRIEF RESEARCH REPORT article

Front. Tuberc
Sec. Epidemiology of Tuberculosis
Volume 2 - 2024 | doi: 10.3389/ftubr.2024.1454277

Test and treat approach for tuberculosis infection amongst household contacts of drug-susceptible pulmonary tuberculosis, Mumbai, India

Provisionally accepted
Daksha Y. Shah Daksha Y. Shah 1Sampada Bhide Sampada Bhide 2Rajesh D. Deshmukh Rajesh D. Deshmukh 3*Jonathan P. Smith Jonathan P. Smith 4Satish Kaiplyawar Satish Kaiplyawar 2Varsha Puri Varsha Puri 1Vijay Yeldandi Vijay Yeldandi 2Anand Date Anand Date 4Melissa R. Nyendak Melissa R. Nyendak 5Christine S. Ho Christine S. Ho 4Patrick K. Moonan Patrick K. Moonan 4*
  • 1 Brihanmumbai Municipal Corporation, Mumbai, Maharashtra, India
  • 2 Society for Health Allied Research and Education, Hyderabad, India
  • 3 Division of Global HIV and Tuberculosis, National Institute of Communicable Diseases, Mumbai, India
  • 4 Centers for Disease Control and Prevention (CDC), Atlanta, United States
  • 5 Centers for Disease Control and Prevention, New Delhi, India

The final, formatted version of the article will be published soon.

    Background: Mumbai is one of the most densely populated areas in the world and is a major contributor to the tuberculosis (TB) epidemic in India. A test and treat approach for TB infection (TBI) amongst household contacts (HHC) is part of the national policy for TB preventive treatment (TPT).However, in practice, tests for infection are limited, and prevalence of TBI in Mumbai is not known.We conducted a cross-sectional study among HHCs exposed to persons with microbiologically-confirmed, drug-susceptible pulmonary TB that were notified for antituberculosis treatment in Mumbai, India during September-December, 2021. Community-based field workers made home visits and offered IGRA (QuantiFERON-TB ® Gold In-Tube Plus) tests to HHC aged >5 years. After ruling out active TB disease, HHC with IGRA-positive test results were referred for TPT. All HHC were monitored for at least 24 months. Results: Among 502 HHCs tested, 273 (54%) had IGRA-positive results. A total of 254 (93%) were classified as TBI and were eligible for TPT, of which 215 (85%) initiated TPT, and 194 (90%) completed TPT. In all, 22 HHCs (4%;22/558) were diagnosed with TB disease; of these, five HHC were diagnosed during follow up, of which three were IGRA positive and had no evidence of disease at initial screening but chose not to initiate TPT. A test and treat strategy for HHC resulted in the detection of a substantial proportion of TBI and secondary TB cases. Home-based IGRA testing led to high participation rates, clinical evaluations, TPT initiation, and early diagnoses of additional secondary cases.

    Keywords: Brief Research Report Figures: 4 Supplemental Table: 1 References: 60 tuberculosis, Contact Tracing, TB infection, gamma-interferon release assay, Latent

    Received: 24 Jun 2024; Accepted: 28 Aug 2024.

    Copyright: © 2024 Shah, Bhide, Deshmukh, Smith, Kaiplyawar, Puri, Yeldandi, Date, Nyendak, Ho and Moonan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Rajesh D. Deshmukh, Division of Global HIV and Tuberculosis, National Institute of Communicable Diseases, Mumbai, India
    Patrick K. Moonan, Centers for Disease Control and Prevention (CDC), Atlanta, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.