Incidence of TB and HIV in prospectively followed household contacts of TB index patients in South Africa.
OBJECTIVE
To report the incidence rates of TB and HIV in household contacts of index patients diagnosed with TB.


METHODS
A prospective cohort study in the Matlosana sub-district of North West Province, South Africa.


METHODS
Contacts of index TB patients received TB and HIV testing after counseling at their first household visit and were then followed up a year later, in 2010. TB or HIV diagnoses that occurred during the period were determined.


RESULTS
For 2,377 household contacts, the overall observed TB incidence rate was 1.3 per 100 person years (95% CI 0.9-1.9/100py) and TB incidence for individuals who were HIV-infected and HIV seronegative at baseline was 5.4/100py (95% CI 2.9-9.0/100py) and 0.7/100py (95% CI 0.3-1.4/100py), respectively. The overall HIV incidence rate was 2.2/100py (95% CI 1.3-8.4/100py).


CONCLUSIONS
In the year following a household case finding visit when household contacts were tested for TB and HIV, the incidence rate of both active TB and HIV infection was found to be extremely high. Clearly, implementing proven strategies to prevent HIV acquisition and preventing TB transmission and progression to disease remains a priority in settings such as South Africa.
The South African Department of Science and Technology/National Research Foundation (DST/NRF) Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), University of Stellenbosch, Stellenbosch, South Africa.
Cari
C
van Schalkwyk
Klerksdorp/Tshepong Hospital Complex, North West Department of Health, Klerksdorp, South Africa; University of the Witwatersrand, Johannesburg, South Africa.
Ebrahim
E
Variava
University of California San Francisco, Department of Internal Medicine, San Francisco, California, United States of America.
Adrienne E
AE
Shapiro
Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
Modiehi
M
Rakgokong
Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
Katlego
K
Masonoke
Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
Limakatso
L
Lebina
The South African Department of Science and Technology/National Research Foundation (DST/NRF) Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), University of Stellenbosch, Stellenbosch, South Africa.
Alex
A
Welte
Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
Neil
N
Martinson
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013019:South Africa / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology*; D055815:Young Adult