title: Tuberculosis burden in China: a high prevalence of pulmonary tuberculosis in household contacts with and without symptoms.
abstract: BACKGROUND
  In the context of decreasing tuberculosis prevalence in China, we examined the effectiveness of screening household contacts of tuberculosis patients.
  
  
  METHODS
  A tuberculosis survey was conducted in 2008. All 3,355 household contacts of notified tuberculosis cases were examined with a questionnaire interview, chest X-ray and three sputum smear tests. The effectiveness was examined by comparing the prevalence of pulmonary tuberculosis in household contacts with or without presenting clinical symptoms against the respective notification rates. Regression models were used to evaluate the factors associated with pulmonary tuberculosis.
  
  
  RESULTS
  Of the 3,355 household contacts, 92 members (2.7%) had pulmonary tuberculosis, among which 46 cases were asymptomatic. The prevalence of pulmonary tuberculosis and smear positive cases in household contacts without symptoms were 20 and 7 times higher than the notification rates in 2008, while those in household contacts with symptoms were 247 and 108 times higher than notification rates, respectively. The patients detected were mainly Index Cases' spouses, sisters/brothers and those who were in contact with female Index Cases.
  
  
  CONCLUSIONS
  The present study provides convincing evidence that household contacts of notified tuberculosis cases are at higher risk of developing tuberculosis. Routine screening for household contacts without any symptoms is recommended for sustained tuberculosis control in China as well as in the world.
authors: Zhongwei
authors: Z
authors: Jia
authors: National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100017, China. smcheng@chinatb.org.
authors: Shiming
authors: S
authors: Cheng
authors: Yan
authors: Y
authors: Ma
authors: Tianhao
authors: T
authors: Zhang
authors: Liqiong
authors: L
authors: Bai
authors: Weiguo
authors: W
authors: Xu
authors: Xiaoxin
authors: X
authors: He
authors: Peiru
authors: P
authors: Zhang
authors: Jinkou
authors: J
authors: Zhao
authors: David C
authors: DC
authors: Christiani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D016358:Contact Tracing; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013183:Sputum / Q000382:microbiology; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission*; D055815:Young Adult