The frequency and determinants of effective contact of tuberculosis patients within their families in Iran (2014-2015)

Background and Objective: Mycobacterium tuberculosis (TB) is mainly an airborne pathogen that is transferred from respiratory droplets of the infected person. Despite the presence of effective medicines and equipped diagnostic devices, TB still is a public health concern. Contact with TB patients is one of the main factors of the TB transmission. Tuberculosis (TB) contact tracing is a valid public health measure to control the spread of TB infection. At present, extensive contact investigation among households is not a routine part of TB control efforts in most countries. We explored the effective contacts of the TB cases to assess the potential risk of transmission and its determinants within their families. Materials and Methods: In this cross-sectional study, registered TB cases (74 patients) in Kerman city, provided information about their family size and type and frequency of unprotected effective contacts within their families from 2014 to 2015. The list of the TB patients that recently diagnosed, was extracted from TB registry software from Tuberculosis center in Kerman. Patients’ inclusion criteria were sputum smear-positive pulmonary TB, suffering from pulmonary TB in chest X-ray, laryngeal TB patients, and TB patients with transmissibility such as having a family. Two experts in the field collected the required information in face to face interview. The demographic variables and the frequency of effective contacts were analyzed using of descriptive statistics and bivariable and multivariable logistic regression model. Odds Ratio (OR) and 95% Confidence Intervals (CI) were reported for variables. The data were analyzed by Stata V. 13 software. Findings: Overall, among the 407 contacts of 74 TB cases, 73% (95%CI: 67%-77%) had effective contacts in their families. Among 74 patients 46 (62.2%) were women. The age range of patients was 20-91 years old and this was 68.2±14.1 for men and 64.7±14.5 for women. 66 patients (89.2%), were Iranian, and 44(59.5%) were married and majority of them 74.3% were illiterate. Having effective contacts was significantly higher among female (Adjusted Odds Ratio [AOR]= 5.1; 95%CI: 1.9-13.7), those with lower literacy status (AOR= 4.0; 95%CI: 1.4-15.1), Afghan patients (AOR= 30.2; 95%CI: 3.4-272.1), those with lower income (AOR= 7.7; 95%CI: 2.2-27.0), those with a house size ≤80 m2 (AOR= 16.6; 95%CI: 5.1-54.3), and those who lived in the rural areas (AOR= 4.9; 95%CI: 1.8-21.9). Conclusion: It seems that the unprotected effective contact with the family members is high among TB patients. This can be a serious concern on the control of TB in this area. Reducing these unprotected effective contacts using education patients and their families besides screening of the family members can help the health sector in decreasing the burden of TB in Iran.

کلیدواژه ها:

Tuberculosis ، Close contact ، unprotected exposure ، Family exposure