title: Risk factors for Mycobacterium tuberculosis infection in Indonesian children living with a sputum smear-positive case.
abstract: OBJECTIVE
  Young children living with infectious tuberculosis (TB) cases are at high risk of infection and disease, and screening is recommended. This is rarely conducted in resource-limited settings. Identifying children most at risk of infection may be useful for setting practical screening policies.
  
  
  METHODS
  Child contacts of smear-positive adult TB patients were invited for Mycobacterium tuberculosis infection and disease screening by symptoms, tuberculin skin test (TST), QuantiFERON-TB Gold In-Tube assay (QFT-GIT) and chest X-ray. Risk factors for infection were collected using a questionnaire and were calculated separately for TST, for QFT-GIT and for both tests combined.
  
  
  RESULTS
  Of 304 screened children 145/302 (48%) were positive using TST, 152/299 (51%) by QFT-GIT and 180/304 (59%) were positive using either or both tests. Positivity for both tests was associated with index case infectivity (acid-fast bacilli [AFB] 3+ vs. AFB 1+: TST OR 2.93, 95%CI 1.59-5.39; QFT-GIT OR 2.28, 95%CI 1.06-4.90) and exposure (child contact's parent is the index case: TST OR 7.04, 95%CI 2.23-22.28; QFT-GIT OR 4.30, 95%CI 1.48-12.45).
  
  
  CONCLUSIONS
  M. tuberculosis infection according to either test was high, supporting screening and preventive treatment. Children of smear-positive TB cases who accompany their parents to the clinic should be prioritised for immediate screening.
authors.affiliation: Centre for International Health, University of Otago, Dunedin, New Zealand. merrin.rutherford@gmail.com
authors.forename: M E
authors.initials: ME
authors.lastname: Rutherford
authors.forename: P C
authors.initials: PC
authors.lastname: Hill
authors.forename: W
authors.initials: W
authors.lastname: Maharani
authors.forename: L
authors.initials: L
authors.lastname: Apriani
authors.forename: H
authors.initials: H
authors.lastname: Sampurno
authors.forename: R
authors.initials: R
authors.lastname: van Crevel
authors.forename: R
authors.initials: R
authors.lastname: Ruslami
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D003430:Cross-Sectional Studies; D005260:Female; D006292:Health Priorities; D006798:Housing; D006801:Humans; D007214:Indonesia; D007223:Infant; D059425:Interferon-gamma Release Tests; D008297:Male; D008403:Mass Screening / Q000379:methods; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D016017:Odds Ratio; D010290:Parents; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013183:Sputum / Q000382:microbiology*; D011795:Surveys and Questionnaires; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000382:microbiology* / Q000635:transmission*