Twelve (12) contacts to an index rifampicin resistant TB patient diagnosed with TB – a case of Mazabuka, Zambia.

Title : Twelve (12) contacts to an index rifampicin resistant TB patient diagnosed with TB – a case of Mazabuka, Zambia.

Abstract:

Background:

Contacts of those infected with TB are at greater risk of contracting TB themselves. The prevalence of TB among contacts of      multidrug-resistant or extensively drug-resistant TB cases is estimated at 3.4%. The risk of progression from TB infection to disease      is highest in the first and second year after infection. TBLON project in collaboration with Southern Provincial Health Office and Mazabuka Hospital traced  contacts of a 23 year old female, a retreatment TB patient who was diagnosed with rifampicin resistant TB (RR TB). At the time of diagnosis, she had been in the pediatrics ward for 3 weeks attending to her 13 month baby who had been admitted for management of severe acute malnutrition.

Intervention:

We elicited close and household contacts including healthcare workers on the pediatric ward, and members of  2 households that she  lived in. One household had 4 rooms and was occupied by 18 members while the other household had 1 room with 6 members. All contacts were screened for TB using both symptom screening and Xpert MTB/Rif; household contacts submitted additional samples for culture irrespective of symptoms. The symptomatic contacts with a negative Xpert MTB/Rif received full clinical evaluation including chest x-ray.

Results:

None of the health care workers were diagnosed with TB. Among the 24 household contacts, 12 contacts were diagnosed with TB. 3 were bacteriologically confirmed with one being rifampicin resistant and 9 were clinically diagnosed. The clinically diagnosed patients included three children aged 13 years, 13 months and 7 months. All patients were either started on or later switched to 2^nd line treatment; all improved on improved on 2^nd line treatment.

Biography:

Marshal Sikandangwa received a diploma in Clinical medicine (Chainama Hills College of Health Sciences - Lusaka, Zambia) in 2002 and a diploma in TB control and epidemiology (Research Institute of Tuberculosis (RIT) - Tokyo Japan )in 2007. In 2017, finished his Degree in Public Health (Texila American University) and in 2019 Masters in Public Health (Texila American University in conjunction with Universidad Central de Nicaragua -UCN)

Marshal started working at a medical clinic in 2002 before moving to the district to coordinator TB and Leprosy program in 2005. The same year (2005), he was promoted to be the provincial coordinator for TB and leprosy the position he had until 2013. In 2013, he worked as provincial TB/HIV liaison Officer until 2017. In 2018, he joined FHI360 and was seconded to the Ministry of Health headquarters as the National Multi Drug Resistant Tuberculosis (MDR-TB) Coordinator. He was move to FHI360 national officer in 2019 as national TB/HIV technical officer the position he held until 2020 when he joined Centre for Infectious Disease research in Zambia as MDR-TB coordinator the position he currently holds.

He has passion for TB and has worked in the development of TB materials and capacity building in the country.