[Tuberculosis contact tracing among children and adolescents, Brazil].
OBJECTIVE
To detect tuberculosis (TB) disease or infection among contacts of pulmonary TB patients.


METHODS
Cross-sectional study in a Primary Healthcare unit in Rio de Janeiro (Brazil) with 184 child and adolescent contacts of pulmonary TB patients between March 1995 and March 1997. Subjects underwent clinical evaluation, chest radiographs, and tuberculin skin tests (TST); sputum smears were performed whenever possible. TB cases found were submitted to treatment and infected patients to chemoprophylaxis. Tuberculin converters, who tested positive for TST eight weeks after an initial negative result, received chemoprophylaxis.


RESULTS
The sample included 98 boys and 86 girls; age ranged from 0 to 15 years; 26.9% were malnourished according to the Gomez criteria. Concerning the source of infection, 170 cases (92.4%) had household contacts, of which 66.5% were the child's parents. BCG vaccination was verified in 98.4% of children, and 14.7% of children had been revaccinated. Strong TST reactions were observed in 110/181 children. Seventy-six children (41.3%) were considered as infected by M. tuberculosis and 25 cases (13.6%) of TB were detected, of which seven (28%) were asymptomatic. There was greater occurrence of disease when the contact lived with more than one source of infection (p=0.02).


CONCLUSIONS
The detection of TB disease and infection was high in the studied population. Contact control must be emphasized, for it allows for the diagnosis of TB in children who are still asymptomatic, in addition to identifying infected subjects who may profit from chemoprophylaxis.
Caldeira
Zelina M R
ZM
Universidade Federal Fluminense, Niterói, RJ, Brazil. zelinacaldeira@uol.com.br
Sant'Anna
Clemax C
CC
Aidé
Miguel Abdom
MA
D000293:Adolescent; D017677:Age Distribution; D001500:BCG Vaccine; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission
D001500:BCG Vaccine