Title : Twelve (12) contacts to an index rifampicin resistant TB patient diagnosed with TB – a case of Mazabuka, Zambia.
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.
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.
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 2nd line treatment; all improved on improved on 2nd line treatment.