Role of tuberculosis symptoms in transmission risk to cell contacts in prisons
Rattachement africain : br, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background: transmission is critical to devising effective strategies to reduce its burden. Whether and to what extent symptoms influence transmission remains poorly understood. Methods: Between 2020 and 2022, we systematically screened persons deprived of liberty (PDL) from three prisons in Brazil for tuberculosis (TB) by symptom assessment and sputum testing with Xpert MTB/RIF Ultra. We performed QuantiFERON-TB Gold Plus (QFT) testing among cell contacts of individuals with TB and in cells with no TB case identified. We evaluated the relationship between TB exposure (symptomatic, asymptomatic and none) and QFT positivity using Bayesian generalised linear mixed models. Results: We screened 7641 PDL for TB and identified 290 cases, yielding a prevalence of 3.8% (290/7641). After applying the exclusion criteria, 686 participants were included for the QFT analysis: 132 contacts of 42 individuals with symptomatic TB, 224 exposed to 52 individuals with asymptomatic TB and 330 with no recent cell exposure. The odds of QFT positivity were higher in symptomatic (adjusted OR (aOR) 2.50, 95% credible interval (CrI) 1.51 to 4.16) and asymptomatic (aOR 1.61, 95% CrI 1.06 to 2.45) exposure groups than in those unexposed. QFT positivity in contacts of symptomatic and asymptomatic TB did not differ (aOR 1.56, 95% CrI 0.92 to 2.63). These associations may be underestimated because of infections acquired outside cell assignments. Conclusions: Approximately two-thirds of individuals with TB lacked symptoms, and their contacts and symptomatic TB contacts had similarly increased risk of QFT positivity compared with individuals without recent cell exposure. These findings indicate that symptom-based screening misses many TB cases. Effective TB control requires systematic screening irrespective of symptoms to interrupt transmission and accelerate diagnosis in high-burden settings.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Role of tuberculosis symptoms in transmission risk to cell contacts in prisons
- Date Crossref
- 01/07/2025
- Éditeur
- BMJ
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Universidade Federal de Mato Grosso do Sul pays non établi dans la noticeUniversité ou école supérieure
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Stanford University Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Universidade Estadual de Mato Grosso do Sul pays non établi dans la noticeUniversité ou école supérieure
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Universidade Federal da Grande Dourados pays non établi dans la noticeUniversité ou école supérieure
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Fundação Oswaldo Cruz pays non établi dans la noticeStructure de recherche
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Yale University pays non établi dans la noticeUniversité ou école supérieure
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School of Medicine Graduate Program in Infectious and Parasitic Diseases pays non établi dans la noticeUniversité ou école supérieure
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State University of Mato Grosso do Sul Nursing Course pays non établi dans la noticeUniversité ou école supérieure
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Federal University of Grande Dourados Health Science Research Laboratory pays non établi dans la noticeUniversité ou école supérieure
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Laboratory of Bacteriology of Central Laboratory pays non établi dans la noticeStructure de recherche
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Yale School of Public Health Department of Epidemiology of Microbial Diseases pays non établi dans la noticeUniversité ou école supérieure
Universidade Federal de Mato Grosso do Sul, Department of Medicine — Stanford University et Universidade Estadual de Mato Grosso do Sul, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.