Contacts of underserved tuberculosis patients have higher odds of TB disease in North West England: A cohort study

T. Wingfield*, P. MacPherson, P. Sodha, A. Tucker, J. Mithoo, S. B. Squire, Paul Cleary

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

OBJECTIVE : To investigate the association between patients' social risk factors and the risk of tuberculous infection and TB disease among their contacts in England. DESIGN: This was a cohort study of all TB cases from NorthWest England diagnosed between 27 March 2012 and 28 June 2016. The social risk factors of TB cases were evaluated to estimate their need for enhanced case management (ECM), from 0 (standard of care) to 3 (intensive social support). RESULTS : A total of 2139 cases and their 10 019 contacts met the eligibility criteria. Being a contact of a patient with smear-positive TB with high ECM or being of Black Caribbean ethnicity was independently associated with greater odds of active TB disease (smearpositive vs. smear-negative, OR 5.3, 95%CI 3.2-8.7; ECM-3 vs. ECM-0, OR 2.2, 95%CI 1.01-5.0; Black Caribbean vs. White, OR 7.4, 95%CI 2.1-25). Being a contact of a patient with smear-positive TB or of Black Caribbean ethnicity was also independently associated with greater odds of tuberculous infection (smearpositive vs. smear-negative, OR 5.3, 95%CI 3.8-7.3; and Black Caribbean vs. White, OR 6.7, 95%CI 2.0- 25). CONCLUSIONS : The social complexity and ethnicity of patients were associated with tuberculous infection and TB disease in their contacts.

Original languageEnglish
Pages (from-to)337-343
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume23
Issue number3
DOIs
Publication statusPublished - 2019

Bibliographical note

Funding Information:
TW is supported by grants from the Wellcome Trust, London (209075/Z/17/Z); the Academy of Medical Sciences, London; the Liverpool Glasgow Wellcome Trust Centre for Global Health Research, Liverpool; the University of Liverpool, Liverpool, UK; the Swedish Health Research Council, Stockholm, Sweden; and the National Institute for Health Research (NIHR), London, UK. PM is funded by the Wellcome Trust (206575/Z/17/Z). JM is part-funded by The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast, Liverpool, UK.

Publisher Copyright:
© 2019 The Union.

Keywords

  • Contact screening
  • Enhanced case management
  • Public health
  • Social and clinical complexity
  • TB
  • TB control
  • TB prevention

Fingerprint

Dive into the research topics of 'Contacts of underserved tuberculosis patients have higher odds of TB disease in North West England: A cohort study'. Together they form a unique fingerprint.

Cite this