Study On Household Close Contacts Investigation Of Sputum-smear-positive Tuberculosis

BackgroundThe household close contact of sputum-smear-positive tuberculosis is the high-risk groups of tuberculosis. Contact investigation was one part of the low-incidence National tuberculosis control Program. China has conducted a nationwide close contact investigation of sputum-smear-positive tuberculosis to find out the potential active tuberculosis since 2007. And up to now, there is no evaluation or research about this program. Review and evaluate this work can provide proof and experience to make the contact investigation in China more effective.Objectives1. Understand the current procedure of contact investigation and outcomes of investigation2. Discuss the ways to improve TB contact investigations strategy3. Recognize factors correlated with the outcomes of the tuberculosis contact investigationMethodsUse the Multi-stage sampling method, we select eight county from four province represent eastern area, central area, western area and Jing-Jin-Hu area as site of this study. According the objectives, this study is divided into two Phases: first, design the questionnaire and collect the data of close contact investigation has been done in 2007, and analysis these data to understand the current procedure and outcomes of close contact investigation in China. The second phase of this study is adjust the procedure of the close contact investigation, then investigate the sputum smear positive tuberculosis and their household close contact. We collect these data and analysis the outcomes of new procedure investigation, then analysis the influencing facts of the outcomes. Compare the two outcomes of this two phases, then discuss the possibility of perfect and improve the procedure of the close contact investigation of the sputum-smear-positive tuberculosis.Results1. The outcomes of two contact investigationComparing the two outcomes, active tuberculosis detection rate in 2008 contact investigation is higher than this rate in 2007, and active pulmonary with suspicious symptoms detection rate in 2008 is higher than the rate in 2007,and the difference of sputum smear positive tuberculosis patient detection rate with no statistically significant.There are 536,938 sputum smear positive tuberculosis patients registered in 2007. We can get three different outcomes if we use different methods to conduct the close contact investigation: According to the 2007 procedure, 7,570 active tuberculosis can be detected; identify the close contact with suspicious symptoms and then give X-ray chest examination and sputum smear examination these contact with suspicious symptoms, 14,960 active tuberculosis can be detected; According to the 2007procedure, 29,900 active tuberculosis can be detected.2. Influencing factors of active tuberculosis detection rate in household contact investigationAccording the Statistical analysis, the influencing factor of active tuberculosis detection rate include: the gender of index, whether have cough symptoms, sputum smear result, contact's age, the relationship between contact and index case, education degree of the close contact, whether live in the same room.Conclusions1. Household close contact investigation of sputum smear positive tuberculosis patient can detect more active tuberculosis.2. The current procedure of Household close contact investigation can be prefect and improve.3. The index patient is female, has cough symptoms, close contact is old, has close relationship with index patient, live the same room with index patient has a higher risk of become active tuberculosis patient.