A prospective evaluation of children under the age of 5 years living in the same household as adults with recently diagnosed pulmonary tuberculosis.
METHODS
A South African suburb with a high tuberculosis incidence (> 800/100,000).


OBJECTIVE
To determine the prevalence of tuberculosis infection and disease in children less than 5 years of age who were in close household contact with adults with pulmonary tuberculosis.


METHODS
Prospective clinical study.


METHODS
Children under 5 years of age (of whom > 98% had been BCG vaccinated in the neonatal period) in household contact with an adult with tuberculosis.


METHODS
Clinical investigation, Mantoux skin testing, chest radiography, gastric aspirate culture for Mycobacterium tuberculosis.


RESULTS
Of 155 children younger than 5 years in contact with 80 index cases (83% smear positive), 14% were infected and 34% diseased. Children aged under 2 years had more severe disease (endobronchial tuberculosis and bronchial compression). Of 154 household members aged over 5 years who were assessed, 17 had culture proven pulmonary tuberculosis (13 smear positive) and a further 16 were placed an antituberculosis treatment on the basis of radiological evidence.


CONCLUSIONS
In a high tuberculosis incidence area evaluation of and chemoprophylaxis for childhood contacts of adults with pulmonary tuberculosis is a rewarding procedure. The detection of culture and smear positive pulmonary tuberculosis amongst adolescent and adult household contacts emphasizes the role of contact tracing in the detection of infectious cases of pulmonary tuberculosis and the prevention of the spread of tuberculosis.
Beyers
N
N
Department of Paediatrics and Child Health, University of Stellenbosch, Faculty of Medicine, Tygerberg, South Africa.
Gie
R P
RP
Schaaf
H S
HS
Van Zyl
S
S
Talent
J M
JM
Nel
E D
ED
Donald
P R
PR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002675:Child, Preschool; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population; D013019:South Africa / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission*