Tuberculosis among household contacts of multidrug-resistant tuberculosis patients in Delhi, India

Abstract

Setting: Lala Ram Sarup Institute of Tuberculosis and Respiratory Diseases (LRS), a tertiary level tuberculosis (TB) institute in Delhi, India.

Objective: To study the profile of TB among household contacts of multidrug-resistant TB (MDR-TB) patients.

Design: In a cross-sectional study, contacts of MDRTB patients were traced and clinical, radiological, bacteriological and pulmonary function tests were performed for evidence of TB infection and active disease.

Results: Between January 2005 and December 2008, 58 of 92 index MDR-TB patients could be traced. Of 302 contacts who could be studied, 16 (5.29%) developed TB: nine had pulmonary and seven had extra- pulmonary disease; two (0.66%) had MDR-TB. Of the 302 contacts, 137 reported to the LRS Institute and were investigated. The most common symptoms observed were cough, chest pain and fever. The tuberculin skin test was positive in 109 of 135 (80.7%) contacts; among these, bacille Calmette-Guérin scar was present in 86. Pulmonary function tests revealed obstruction, restriction and mixed abnormalities.

Conclusion: The majority of contacts of MDR-TB patients had drug-susceptible TB and the rate of MDRTB was very low. Evaluation of contacts of MDR-TB cases may lead to early diagnosis and prevention of TB.