Faculty of Medicine

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    Tuberculosis contact tracing yield and associated factors in Uganda
    (BMC Pulmonary Medicine, 2022-02-09) Baruch Baluku, Joseph; Nabwana, Martin; Winters, Muttamba; Bongomin, Felix
    Background: The yield of tuberculosis (TB) contact tracing is historically low in Uganda. We determined factors asso ciated with a positive contact tracing yield at an urban public TB clinic in Kampala, Uganda. Methods: We reviewed contact tracing registers of index TB cases registered between 2015 and 2020 at Kitebi Health Center, a primary level facility. Contacts who had symptoms of TB were designated as having presumptive TB. A contact investigation that yielded a new TB case was designated as a positive yield. We used logistic regression to determine factors associated with a positive yield of contact tracing. Results: Of 778 index TB cases, 455 (58.5%) had a contact investigation conducted. Index cases with a telephone contact in the unit TB register (adjusted odds ratio (aOR) 1.66, 95% CI 1.02–1.97, p=0.036) were more likely to have a contact investigation conducted than those who did not. Of 1350 contacts, 105 (7.8%) had presumptive TB. Of these, 73 (69.5%) were further evaluated for active TB and 29 contacts had active TB. The contact tracing yield for active TB was therefore 2.1% (29/1,350). The odds of a positive yield increased tenfold with each additional presumptive contact evaluated for active TB (aOR 10.1, 95% CI 2.95–34.66, p<0.001). Also, retreatment index TB cases were more likely to yield a positive contact (aOR 7.69 95% CI 2.08–25.00, p=0.002) than to new cases. Conclusion: TB contact tracing should aim to evaluate all contacts with presumptive TB and contacts of retreatment cases to maximise the yield of contact tracing.