ABSTRACT
BACKGROUND: As long as one case of tuberculosis is replaced by another, elimination of tuberculosis cannot be achieved. Contact tracing is an important strategy for detection of more TB cases early. The present study is concerned with an innovative method of contact tracing. METHODS: A quasi randomized interventional study was conducted in two TB Units of Kashmir for evaluation of newly designed interventional model for its effectiveness, acceptance and feasibility. Data was collected from 1st Jan 2014 to 30th June 2015. RESULTS: In interventional group of 598 eligible household contacts, total 27 (4.51%) contacts were detected as suffering from active pulmonary TB cases. Out these, 21 (3.51%) cases were diagnosed during initial home visit and 6 (1.04%) cases were diagnosed at 6th monthly follow up visit. In controlled group 593 eligible household contacts, total 7 (1.18%) contacts were found suffering from active pulmonary -TB during routine practice under RNTCP for contact screening. In interventional group, during initial home visit by the investigator, 423 (70.74%) of household contacts participated for study and during follow up visit at 6th month, 356 (59.53%) household contacts participated. CONCLUSION: Newly designed "home-based intervention model" for active-case finding among household contacts of index pulmonary-TB case has been found an effective method for contact tracing. This intervention has adequate acceptance by the community and feasible for implementation under existing revised national tuberculosis control programme.
ABSTRACT
BACKGROUND: There are various biological, behavioural and social determinants associated with the epidemiology of pulmonary tuberculosis (P-TB) which have been extensively described in literature. Present study was conducted to know the influence of such factors on the "home-based interventional model" for active case finding among household contacts of index P-TB cases. METHODS: In a quasi-randomized controlled interventional study, the "home-based interventional model" for active case finding was applied to index P-TB cases and their household contacts of interventional group of study subjects. Study was conducted from January 2014 to June 2015 for evaluation of the model in comparison to the existing usual practice of contact tracing. Baseline data regarding factors associated with epidemiology of P-TB likely to influence effectiveness of intervention were collected, collated and analysed. RESULTS: The overall acceptance of intervention was 70.74% which was statically significantly influenced by gender (p<0.0001), age group (p=0.0006), education (p<0.0001), occupation (p<0.0001) and relationship of household contacts with index case (p<0.0001). Total 27 (4.51%) cases were detected among contacts. Out of personal and family level characteristics "relationship with index case" (p=0.0418) and "overcrowding in house" (p=0.0017) were found to statistically significantly influencing the effectiveness of interventional model. The prevalent risk factors for TB among contacts, level of exposer of household contacts to index cases, grade sputum positivity and type of index case were not found statistically significantly influencing the yield of interventional model. CONCLUSION: Factors/determinants influencing the applicability of interventional model for active case finding among household contacts were identified and their impact on acceptance and yield of intervention was assessed.
