title: Contacts of retreatment tuberculosis cases with a prior poor treatment outcome are at increased risk of latent tuberculosis infection.
abstract: OBJECTIVE
  To estimate the prevalence of and risk factors for latent tuberculosis infection (LTBI) among contacts of index patients with tuberculosis (TB) with a prior history of active TB disease and TB treatment (retreatment cases).
  
  
  METHODS
  A cross-sectional population-based study was conducted using data from the national TB contact surveillance program in the country of Georgia. Contacts of retreatment cases were investigated and tuberculin skin testing was offered. Bivariate and multivariable analyses were performed to calculate odds ratios (OR) and 95% confidence intervals for risk of LTBI among contacts.
  
  
  RESULTS
  The prevalence of LTBI was significantly higher among contacts whose index TB patient had had a prior unfavorable treatment outcome compared to those who had had a favorable outcome (OR 3.14). Contacts whose index TB case had previously failed therapy (OR 6.43), was lost to follow-up (OR 5.63), or had completed treatment (OR 3.33) had a significantly higher prevalence of LTBI compared to contacts of previously cured TB cases.
  
  
  CONCLUSIONS
  Among contacts of active TB retreatment cases, the risk of LTBI was related to the outcome of the index case's previous TB treatment. Efforts aimed at reducing treatment loss to follow-up should be emphasized to enhance TB control efforts and may also decrease LTBI and active TB among contacts.
authors.affiliation: National Center for Disease Control and Public Health, 9 Asatiani St., 0177 Tbilisi, Georgia. Electronic address: d.baliashvili@ncdc.ge.
authors.forename: Davit
authors.initials: D
authors.lastname: Baliashvili
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Magee
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Russell R
authors.initials: RR
authors.lastname: Kempker
authors.affiliation: National Center for Disease Control and Public Health, 9 Asatiani St., 0177 Tbilisi, Georgia.
authors.forename: Giorgi
authors.initials: G
authors.lastname: Kuchukhidze
authors.affiliation: National Center for Disease Control and Public Health, 9 Asatiani St., 0177 Tbilisi, Georgia.
authors.forename: Ana
authors.initials: A
authors.lastname: Aslanikashvili
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA; Departments of Epidemiology and Global Health, Rollins School of Public Health of Emory University, Atlanta, Georgia, USA.
authors.forename: Henry M
authors.initials: HM
authors.lastname: Blumberg
mesh_terms: D000328:Adult; D000368:Aged; D016358:Contact Tracing; D003430:Cross-Sectional Studies; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D062486:Public Health Surveillance; D019233:Retreatment; D012307:Risk Factors; D016896:Treatment Outcome; D014374:Tuberculin Test
keywords: Georgia; LTBI; TST; Tuberculosis