title: Evaluation of TB Case Finding through Systematic Contact Investigation, Chhattisgarh, India.
abstract: Rationale. Contact investigation is an established tool for early case detection of tuberculosis (TB). In India, contact investigation is not often conducted, despite national policy, and the yield of contact investigation is not well described. Objective. To determine the yield of evaluating household contacts of sputum smear-positive TB cases in Rajnandgaon district, Chhattisgarh, India. Methods. Among 14 public health care facilities with sputum smear microscopy services, home visits were conducted to identify household contacts of all registered sputum smear-positive TB cases. We used a standardized protocol to screen for clinical symptoms suggestive of active TB with additional referral for chest radiograph and sputa collection. Results. From December 2010 to May 2011, 1,556 household contacts of 312 sputum smear-positive TB cases were identified, of which 148 (9.5%) were symptomatic. Among these, 109 (73.6%) were evaluated by sputum examination resulting in 11 cases (10.1%) of sputum smear-positive TB and 4 cases (3.6%) of smear-negative TB. Household visits contributed additional 63% TB cases compared to passive case detection alone. Conclusion. A standard procedure for conducting household contact investigation identified additional TB cases in the community and offered an opportunity to initiate isoniazid chemoprophylaxis among children.
authors.affiliation: World Health Organization, Country Office for India, New Delhi 110011, India.
authors.forename: Kshitij
authors.initials: K
authors.lastname: Khaparde
authors.affiliation: District TB Office, Rajnandgaon, Chhattisgarh 491441, India.
authors.forename: Pawan
authors.initials: P
authors.lastname: Jethani
authors.affiliation: Bill and Melinda Gates Foundation, New Delhi 110015, India.
authors.forename: Puneet K
authors.initials: PK
authors.lastname: Dewan
authors.affiliation: World Health Organization, Country Office for India, New Delhi 110011, India.
authors.forename: Sreenivas A
authors.initials: SA
authors.lastname: Nair
authors.affiliation: District TB Office, Rajnandgaon, Chhattisgarh 491441, India.
authors.forename: Madhav Rao
authors.initials: MR
authors.lastname: Deshpande
authors.affiliation: The Union, South-East Asia Regional Office, New Delhi 110016, India.
authors.forename: Srinath
authors.initials: S
authors.lastname: Satyanarayana
authors.affiliation: World Health Organization, Country Office for India, New Delhi 110011, India.
authors.forename: Shamim
authors.initials: S
authors.lastname: Mannan
authors.affiliation: Division of Tuberculosis Elimination, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329-4027, USA.
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Moonan