Secondary Attack Rate of Tuberculosis in Urban Households in Kampala, Uganda
Identifieur interne : 001168 ( Ncbi/Merge ); précédent : 001167; suivant : 001169Secondary Attack Rate of Tuberculosis in Urban Households in Kampala, Uganda
Auteurs : Christopher C. Whalen [États-Unis] ; Sarah Zalwango [Ouganda] ; Allan Chiunda [États-Unis] ; Lashaunda Malone [États-Unis] ; Kathleen Eisenach [États-Unis] ; Moses Joloba [Ouganda] ; W. Henry Boom [États-Unis] ; Roy Mugerwa [Ouganda]Source :
- PLoS ONE [ 1932-6203 ] ; 2011.
Abstract
Tuberculosis is an ancient disease that continues to threaten individual and public health today, especially in sub-Saharan Africa. Current surveillance systems describe general risk of tuberculosis in a population but do not characterize the risk to an individual following exposure to an infectious case.
In a study of household contacts of infectious tuberculosis cases (n = 1918) and a community survey of tuberculosis infection (N = 1179) in Kampala, Uganda, we estimated the secondary attack rate for tuberculosis disease and tuberculosis infection. The ratio of these rates is the likelihood of progressive primary disease after recent household infection.
The secondary attack rate for tuberculosis disease was 3.0% (95% confidence interval: 2.2, 3.8). The overall secondary attack rate for tuberculosis infection was 47.4 (95% confidence interval: 44.3, 50.6) and did not vary widely with age, HIV status or BCG vaccination. The risk for progressive primary disease was highest among the young or HIV infected and was reduced by BCG vaccination.
Early case detection and treatment may limit household transmission of
Url:
DOI: 10.1371/journal.pone.0016137
PubMed: 21339819
PubMed Central: 3038854
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PMC:3038854Le document en format XML
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<author><name sortKey="Joloba, Moses" sort="Joloba, Moses" uniqKey="Joloba M" first="Moses" last="Joloba">Moses Joloba</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Tuberculosis is an ancient disease that continues to threaten individual and public health today, especially in sub-Saharan Africa. Current surveillance systems describe general risk of tuberculosis in a population but do not characterize the risk to an individual following exposure to an infectious case.</p>
</sec>
<sec><title>Methods</title>
<p>In a study of household contacts of infectious tuberculosis cases (n = 1918) and a community survey of tuberculosis infection (N = 1179) in Kampala, Uganda, we estimated the secondary attack rate for tuberculosis disease and tuberculosis infection. The ratio of these rates is the likelihood of progressive primary disease after recent household infection.</p>
</sec>
<sec><title>Results</title>
<p>The secondary attack rate for tuberculosis disease was 3.0% (95% confidence interval: 2.2, 3.8). The overall secondary attack rate for tuberculosis infection was 47.4 (95% confidence interval: 44.3, 50.6) and did not vary widely with age, HIV status or BCG vaccination. The risk for progressive primary disease was highest among the young or HIV infected and was reduced by BCG vaccination.</p>
</sec>
<sec><title>Conclusions</title>
<p>Early case detection and treatment may limit household transmission of <italic>M. tuberculosis</italic>
. Household members at high risk for disease should be protected through vaccination or treatment of latent tuberculosis infection.</p>
</sec>
</div>
</front>
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<author><name sortKey="Bass, Jb" uniqKey="Bass J">JB Bass</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rieder, Hl" uniqKey="Rieder H">HL Rieder</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">21339819</article-id>
<article-id pub-id-type="pmc">3038854</article-id>
<article-id pub-id-type="publisher-id">PONE-D-10-00537</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0016137</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v2"><subject>Biology</subject>
<subj-group><subject>Population Biology</subject>
<subj-group><subject>Epidemiology</subject>
<subj-group><subject>Infectious Disease Epidemiology</subject>
<subject>Social Epidemiology</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject>
<subj-group><subject>Clinical Research Design</subject>
<subj-group><subject>Epidemiology</subject>
<subject>Longitudinal Studies</subject>
<subject>Observational Studies</subject>
<subject>Prospective Studies</subject>
<subject>Statistical Methods</subject>
<subject>Survey Research</subject>
</subj-group>
</subj-group>
<subj-group><subject>Epidemiology</subject>
<subj-group><subject>Epidemiological Methods</subject>
<subject>Infectious Disease Epidemiology</subject>
<subject>Molecular Epidemiology</subject>
<subject>Social Epidemiology</subject>
</subj-group>
</subj-group>
<subj-group><subject>Infectious Diseases</subject>
<subj-group><subject>Bacterial Diseases</subject>
<subj-group><subject>Tuberculosis</subject>
</subj-group>
</subj-group>
<subj-group><subject>Infectious Disease Control</subject>
<subject>Tropical Diseases (Non-Neglected)</subject>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Secondary Attack Rate of Tuberculosis in Urban Households in Kampala, Uganda</article-title>
<alt-title alt-title-type="running-head">Household Attack Rates for Tuberculosis</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Whalen</surname>
<given-names>Christopher C.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zalwango</surname>
<given-names>Sarah</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chiunda</surname>
<given-names>Allan</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Malone</surname>
<given-names>LaShaunda</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Eisenach</surname>
<given-names>Kathleen</given-names>
</name>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Joloba</surname>
<given-names>Moses</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Boom</surname>
<given-names>W. Henry</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mugerwa</surname>
<given-names>Roy</given-names>
</name>
<xref ref-type="aff" rid="aff5"><sup>5</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<addr-line>Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, United States of America</addr-line>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>Tuberculosis Research Unit, Makerere University, Kampala, Uganda</addr-line>
</aff>
<aff id="aff3"><label>3</label>
<addr-line>Department of Medicine, Case Western Reserve University, School of Medicine and University Hospitals of Cleveland, Cleveland, Ohio, United States of America</addr-line>
</aff>
<aff id="aff4"><label>4</label>
<addr-line>Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America</addr-line>
</aff>
<aff id="aff5"><label>5</label>
<addr-line>Department of Medicine, Makerere University Medical School, Kampala, Uganda</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Marais</surname>
<given-names>Ben</given-names>
</name>
<degrees></degrees>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">University of Stellenbosch, South Africa</aff>
<author-notes><corresp id="cor1">* E-mail: <email>ccwhalen@uga.edu</email>
</corresp>
<fn fn-type="con"><p>Conceived and designed the experiments: CCW KE MJ WHB RM. Performed the experiments: SZ KE MJ. Analyzed the data: CCW AC LM. Contributed reagents/materials/analysis tools: KE MJ WHB. Wrote the paper: CCW. Supervised field activities: SZ RM.</p>
</fn>
</author-notes>
<pub-date pub-type="collection"><year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>14</day>
<month>2</month>
<year>2011</year>
</pub-date>
<volume>6</volume>
<issue>2</issue>
<elocation-id>e16137</elocation-id>
<history><date date-type="received"><day>6</day>
<month>8</month>
<year>2010</year>
</date>
<date date-type="accepted"><day>14</day>
<month>12</month>
<year>2010</year>
</date>
</history>
<permissions><copyright-statement>Whalen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</copyright-statement>
</permissions>
<abstract><sec><title>Background</title>
<p>Tuberculosis is an ancient disease that continues to threaten individual and public health today, especially in sub-Saharan Africa. Current surveillance systems describe general risk of tuberculosis in a population but do not characterize the risk to an individual following exposure to an infectious case.</p>
</sec>
<sec><title>Methods</title>
<p>In a study of household contacts of infectious tuberculosis cases (n = 1918) and a community survey of tuberculosis infection (N = 1179) in Kampala, Uganda, we estimated the secondary attack rate for tuberculosis disease and tuberculosis infection. The ratio of these rates is the likelihood of progressive primary disease after recent household infection.</p>
</sec>
<sec><title>Results</title>
<p>The secondary attack rate for tuberculosis disease was 3.0% (95% confidence interval: 2.2, 3.8). The overall secondary attack rate for tuberculosis infection was 47.4 (95% confidence interval: 44.3, 50.6) and did not vary widely with age, HIV status or BCG vaccination. The risk for progressive primary disease was highest among the young or HIV infected and was reduced by BCG vaccination.</p>
</sec>
<sec><title>Conclusions</title>
<p>Early case detection and treatment may limit household transmission of <italic>M. tuberculosis</italic>
. Household members at high risk for disease should be protected through vaccination or treatment of latent tuberculosis infection.</p>
</sec>
</abstract>
<counts><page-count count="7"></page-count>
</counts>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Ouganda</li>
<li>États-Unis</li>
</country>
<region><li>Arkansas</li>
<li>Géorgie (États-Unis)</li>
<li>Ohio</li>
</region>
</list>
<tree><country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Whalen, Christopher C" sort="Whalen, Christopher C" uniqKey="Whalen C" first="Christopher C." last="Whalen">Christopher C. Whalen</name>
</region>
<name sortKey="Boom, W Henry" sort="Boom, W Henry" uniqKey="Boom W" first="W. Henry" last="Boom">W. Henry Boom</name>
<name sortKey="Chiunda, Allan" sort="Chiunda, Allan" uniqKey="Chiunda A" first="Allan" last="Chiunda">Allan Chiunda</name>
<name sortKey="Eisenach, Kathleen" sort="Eisenach, Kathleen" uniqKey="Eisenach K" first="Kathleen" last="Eisenach">Kathleen Eisenach</name>
<name sortKey="Malone, Lashaunda" sort="Malone, Lashaunda" uniqKey="Malone L" first="Lashaunda" last="Malone">Lashaunda Malone</name>
</country>
<country name="Ouganda"><noRegion><name sortKey="Zalwango, Sarah" sort="Zalwango, Sarah" uniqKey="Zalwango S" first="Sarah" last="Zalwango">Sarah Zalwango</name>
</noRegion>
<name sortKey="Joloba, Moses" sort="Joloba, Moses" uniqKey="Joloba M" first="Moses" last="Joloba">Moses Joloba</name>
<name sortKey="Mugerwa, Roy" sort="Mugerwa, Roy" uniqKey="Mugerwa R" first="Roy" last="Mugerwa">Roy Mugerwa</name>
</country>
</tree>
</affiliations>
</record>
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