Missed opportunities for screening child contacts of smear-positive tuberculosis in Zambia, a high-prevalence setting.
To evaluate whether contact screening recommendations for child household contacts of adult smear-positive tuberculosis (TB) cases were implemented in Lusaka, Zambia.



A cross-sectional survey of smear-positive adults receiving anti-tuberculosis treatment was conducted. The main outcomes were proportions of TB patients with under-five children who were aware, informed and/or had a child screened and/or commenced on isoniazid (INH).



Of 371 TB patients (median age 33 years, 70% males), 259 (70%) lived with a child aged <15 years, of whom 48% (177) were aged <5 years. Overall, 32% (n = 119) were aware about child contact screening; 49% were informed by community agents vs. 38% by health care providers. Of the 259 TB patients with children, 32% (n = 84) were aware of contact screening, 32% (56/177) of whom had children aged <5 years. Of the 92/259 (36%) who were asked to have their children screened by the health care provider, 19% (49) complied. Of 177 eligible children, 11% (n = 20) were commenced on INH. Patients were more likely to comply when informed by the health care provider vs. the community agent.



Screening of child contacts of adult smear-positive TB patients in areas with a large burden of adult disease is not routinely implemented. Interventions are required to ensure compliance with contact screening recommendations.
Department of Paediatrics, University Teaching Hospital, Lusaka, School of Medicine, University of Zambia, Lusaka, Lusaka.
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Chabala
School of Medicine, University of Zambia, Lusaka, Lusaka.
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Chongwe
Pendleton Family Practice, Lusaka, Zambia, Lusaka.
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Jumbe-Marsden
Department of Paediatrics, University Teaching Hospital, Lusaka, School of Medicine, University of Zambia, Lusaka.
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Somwe
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D016358:Contact Tracing; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006282:Health Personnel; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012959:Socioeconomic Factors; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission*; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology
D000995:Antitubercular Agents; D007538:Isoniazid