An Audit of Symptomatic Household Contact Tracing of Sputum Smear Positive TB Patients enrolled at TB DOTS centre in Nishtar Medical University Multan, South Punjab, Pakistan.

Abstract

ABSTRACTBackground:                  Tuberculosis still remain one of the biggest issue in our part of the world. Pulmonary tuberculosis is special in this regard that it spreads through coughing and those persons who are in close proximity of such patients specially smear positive cases are at stake of developing the same disease. So, the basic purpose of this study was to screen such persons who are in close proximity of smear positive pulmonary tuberculosis patients.Materials and Methods:                    This Audit was conducted among the household contacts of all newly diagnosed Sputum Smear positive pulmonary TB patients which were being diagnosed at/referred to the DOTS centre, Pulmonology department Nishtar Medical University Multan from 1st January 2017 to 31th December 2018. Cases included in the study were from both rural and urban areas.Results:                      The household contacts of 661 index cases (CAT- I TB 589 & CAT- II TB 72)   which were registered at DOTS centre in Pulmonology department Nishtar Medical University Multan from 1st January 2017 to 31th December 2018 were considered for inclusion in the study. Among 661 Index cases 6 were further diagnosed as Primary MDR (1.01%) on CAT 1 treatment and 4 were diagnosed as MDR (5.55%) on CAT- II patients.                 Among 1336 household symptomatic contacts 43 cases (3.21%) were found to be smear positive. Among these 43 cases 26 were male (60.46%) and 17 were female (39.53%).Conclusion:               Our study concluded that 3.21% persons were smear positive among 1336 symptomatic contacts of the Index cases. This method of contact tracing is easy and need no heavy financing as well. WHO also endorses such approach of contact tracing. The focus on symptomatic contacts offers a cost effective alternative and the findings of this study suggest the need for more research to assess the cost effectiveness and large scale adoption of household contact tracing for detection of TB in Pakistan