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Abstract：
In Indonesia, the implementation of tuberculosis (TB) contact investigation is limited, with low detection rates. We report the yield of and risk factors for TB disease and infection for household contacts (HHCs) investigated using chest X-ray (CXR) screening. We identified HHCs aged five years and above of bacteriologically confirmed index cases from 2018 to 2022 in Yogyakarta City and Kulon Progo. All HHCs were offered screening for TB symptoms; TB infection testing with either tuberculin skin testing or interferon gamma release assay; and referral for CXR. Sputum from those with symptoms or CXR suggestive of TB was tested with Xpert MTB/RIF. Risk factors for active TB disease and latent TB infection (LTBI) were identified by logistic regression models. We screened 2857 HHCs for TB between June 2020 and December 2022, with 68 (2.4%) diagnosed with active TB. Of 2621 HHCs eligible for LTBI investigation, 1083 (45.7%) were diagnosed with LTBI. The factors associated with active TB were age, being underweight, diabetes mellitus, urban living, and sleeping in the same house as an index case. Factors associated with LTBI were increasing age and male gender. Conclusions: Screening for HHC including CXR and TST/IGRA yielded a moderate prevalence of TB disease and infection.
摘要：
在印度尼西亚,结核病（TB）接触调查的实施是有限的，低检测率。我们报告了使用胸部X射线（CXR）筛查调查的家庭接触者（HHCs）的结核病和感染的产量和危险因素。从2018年至2022年，我们在日惹市和库隆普罗戈确定了年龄在5岁及以上的细菌学证实的指标病例。对所有HHC进行了结核病症状筛查；使用结核菌素皮肤测试或干扰素γ释放测定进行结核病感染测试；并推荐CXR。用XpertMTB/RIF测试了有症状或CXR提示TB的患者的痰。通过逻辑回归模型确定活动性结核病和潜伏性结核病感染（LTBI）的危险因素。我们在2020年6月至2022年12月期间对2857例HHC进行了结核病筛查，其中68例（2.4%）被诊断为活动性结核病。在符合LTBI调查资格的2621个HHC中，1083例（45.7%）被诊断为LTBI。与活动性结核病相关的因素是年龄，体重不足，糖尿病,城市生活,和索引案件睡在同一所房子里。与LTBI相关的因素是年龄增长和男性性别。结论：包括CXR和TST/IGRA在内的HHC筛查产生了中度的TB疾病和感染患病率。
