Project Details

Assessing the Infectiousness of Minimal Tuberculosis Toward Pediatric Household Contacts

Edson Marambire, BScN, MPH, PhD

Summary

BACKGROUND: Children bear a substantial - and largely preventable - burden of tuberculosis (TB) infection driven by household exposure to infectious adults. While many adults have undiagnosed radiologically apparent but bacteriologically unconfirmed TB ("minimal TB"), they unknowingly transmit Mycobacterium tuberculosis (Mtb) to vulnerable child contacts, and whether adults with minimal TB are infectious, and whether treating them reduces transmission to children, remains unknown. GAP: No known studies have quantified Mtb transmission from individuals with minimal TB or early, screen-detected TB to child contacts, compared to transmission from treated vs untreated minimal TB as well described transmission risk factors. HYPOTHESIS: Hypothesis 1: Adults with minimal TB transmit Mtb to child household contacts and initiating TB treatment to adults with minimal TB reduces transmission. Hypothesis 1: A combination of individual and household level risk factors contribute to Mtb infection among child household contacts of adults with minimal TB. METHODS: The study will enroll child household contacts aged 2–14.9 years living with adults diagnosed with minimal TB (estimated n≈180) who are randomised to no or different duration of TB treatment. Participants will undergo Cy-Tb skin testing, administered and read at 48–72 hours. RESULTS: Pending. IMPACT: This study will generate critical evidence on the infectiousness of adults with minimal TB and the potential of early diagnosis and treatment to interrupt Mtb transmission to children. By directly linking adult case-finding with paediatric infection outcomes, findings will inform TB screening policies and preventive strategies aimed at reducing childhood Mtb infection and disease in high-burden settings Website Link: www.thruzim.org