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. 2011 Feb 14;6(2):e16137.
doi: 10.1371/journal.pone.0016137.

Secondary attack rate of tuberculosis in urban households in Kampala, Uganda

Christopher C Whalen  1 , Sarah Zalwango, Allan Chiunda, LaShaunda Malone, Kathleen Eisenach, Moses Joloba, W Henry Boom, Roy Mugerwa
Affiliations

Secondary attack rate of tuberculosis in urban households in Kampala, Uganda

Christopher C Whalen et al. PLoS One. .

Abstract

Background: Tuberculosis is an ancient disease that continues to threaten individual and public health today, especially in sub-Saharan Africa. Current surveillance systems describe general risk of tuberculosis in a population but do not characterize the risk to an individual following exposure to an infectious case.

Methods: In a study of household contacts of infectious tuberculosis cases (n = 1918) and a community survey of tuberculosis infection (N = 1179) in Kampala, Uganda, we estimated the secondary attack rate for tuberculosis disease and tuberculosis infection. The ratio of these rates is the likelihood of progressive primary disease after recent household infection.

Results: The secondary attack rate for tuberculosis disease was 3.0% (95% confidence interval: 2.2, 3.8). The overall secondary attack rate for tuberculosis infection was 47.4 (95% confidence interval: 44.3, 50.6) and did not vary widely with age, HIV status or BCG vaccination. The risk for progressive primary disease was highest among the young or HIV infected and was reduced by BCG vaccination.

Conclusions: Early case detection and treatment may limit household transmission of M. tuberculosis. Household members at high risk for disease should be protected through vaccination or treatment of latent tuberculosis infection.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Distribution of tuberculosis and latent tuberculosis infection among 2415 households in Kampala Uganda, 1995–2004.
Figure 2
Figure 2. Prevalence of latent tuberculosis infection (TST≥10 mm) and risk difference according to age among household contacts and community controls in Kampala, Uganda, 1995–2004.
See this image and copyright information in PMC

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