%0 Journal Article
%T Contact Investigation of Children Exposed to Tuberculosis in South East Asia: A Systematic Review
%A Rina Triasih
%A Merrin Rutherford
%A Trisasi Lestari
%A Adi Utarini
%A Colin F. Robertson
%A Stephen M. Graham
%J Journal of Tropical Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/301808
%X Background. Screening of children who are household contacts of tuberculosis (TB) cases is universally recommended but rarely implemented in TB endemic setting. This paper aims to summarise published data of the prevalence of TB infection and disease among child contacts in South East Asia. Methods. Search strategies were developed to identify all published studies from South East Asia of household contact investigation that included children (0¨C15 years). Results. Eleven studies were eligible for review. There was heterogeneity across the studies. TB infection was common among child contacts under 15 years of age (24.4¨C69.2%) and was higher than the prevalence of TB disease, which varied from 3.3% to 5.5%. Conclusion. TB infection is common among children that are household contacts of TB cases in South East Asia. Novel approaches to child contact screening and management that improve implementation in South East Asia need to be further evaluated. 1. Introduction South East Asia is home to one-third of the global burden of tuberculosis (TB), with an estimated 5 million prevalent cases and an annual incidence of 3 million TB cases. Five of the 11 countries in the region are among the 22 high-burden countries, with India accounting for over 20% of the global burden of TB disease [1, 2]. Using the current strategy of passive case finding, the case detection rate in the region has improved from around 40% in 2002 to 65% in 2008. However, it has stagnated since 2006 and remains below the target of more than 70% [3]. A lower than expected case detection rate indicates that TB cases in the community are not being adequately identified and treated, which means ongoing transmission of TB infection [4]. The risk of transmission increases with the closeness of contact, overcrowded living conditions, and the degree of infectiousness of a TB case as determined by the positivity of sputum smear microscopy of acid-fast bacilli (AFB) and degree of lung field involvement in the chest X-ray (CXR) [5, 6]. Close contacts to a TB case such as those living in the same household are at higher risk of infection than casual contacts. Among those that are infected, young children (<5 years) or those with immunodeficiency (e.g., HIV infected) are at increased risk of developing TB disease, usually within two years following infection [7]. Therefore, the World Health Organization (WHO), the International Union against Tuberculosis and Lung Diseases (IUATLD) and the National TB Control Programs (NTPs) recommend screening of all children who are household contacts of sputum
%U http://www.hindawi.com/journals/jtm/2012/301808/