Long-term follow-up of contacts exposed to multidrug-resistant tuberculosis in Victoria, Australia, 1995–2010

Denholm, J.T., Leslie, D.E., Jenkins, G.A., Darby, J., Johnson, P.D.R., Graham, S.M., Brown, G.V., Sievers, A., Globan, M., Brown, L.K., and McBryde, E.S. (2012) Long-term follow-up of contacts exposed to multidrug-resistant tuberculosis in Victoria, Australia, 1995–2010. International Journal of Tuberculosis and Lung Disease, 16 (10). pp. 1320-1325.

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Abstract

Setting: The effectiveness of public health strategies following exposure to multidrug-resistant tuberculosis (MDR-TB) is not clear.

Objective: To perform long-term follow-up of MDR-TB contacts and review individual outcomes and management approaches.

Design: Retrospective review of MDR-TB contacts identified by the Victorian Department of Health from 1995 to 2010. Health records, including personal medical and pharmacy records and statewide clinical and laboratory TB databases, were searched to identify management strategies and individual outcomes.

Results: A total of 570 contacts of 47 MDR-TB cases were identified, with a total follow-up period of 3093 person-years of observation (PYO) since exposure. Of 570 contacts, 49 (8.6%) were considered likely to have been infected with Mycobacterium tuberculosis from index cases, and 11/49 (22.5%) of these were prescribed preventive therapy tailored to isolate susceptibility. No MDR-TB cases occurred in those receiving preventive treatment, while two cases were observed in those not treated (incidence 2878/100 000 PYO during the first 2 years post exposure).

Conclusions: The risk of MDR-TB transmission to close contacts in this low-prevalence setting highlights the potential for public health strategies involving preventive treatment.

Item ID: 39758
Item Type: Article (Refereed Research - C1)
Keywords: contact tracing; drug resistant; public health; tuberculosis
ISSN: 1815-7920
Date Deposited: 12 Oct 2015 04:08
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 40%
16 STUDIES IN HUMAN SOCIETY > 1605 Policy and Administration > 160508 Health Policy @ 20%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 50%
92 HEALTH > 9202 Health and Support Services > 920207 Health Policy Evaluation @ 50%
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