To test not to test: Household Contact screening of Tuberculosis patients in urban slum, Dhaka

Background: Bangladesh, one of the high burden countries for tuberculosis (TB), is facing challenges in urban TB control. The migrant nature of the slum residents (66%), overcrowding, and poor living condition contribute to... [ view full abstract ]

Background: Bangladesh, one of the high burden countries for tuberculosis (TB), is facing challenges in urban TB control. The migrant nature of the slum residents (66%), overcrowding, and poor living condition contribute to disease transmission. Therefore contacts of TB patients are regarded as one of the high risk groups for TB.
Objective: To determine the proportion of household adherent to contact screening and related factors, in selective urban areas of Bangladesh. Another objective was to determine the proportion of households with child members tested for TB.
Method: We interviewed 481 TB patients and 462 household members from households of all 943 index TB patients, enrolled in eight urban DOTS centres of Dhaka, Bangladesh to identify the proportion of adherent. Adherent refers to households of TB patients with at least one contact screened for TB. Unadjusted and multivariable logistic regressions were used to determine the factors associated with adherence to contact screening.
Results: Adult contacts of 110 (12%) households reported TB screening. Only 59 (9%) households with child member reported TB screening of children; among them, 12 (20%) children were detected with TB. Households with index TB patient below 15 years, were more likely to have contact screening compared to other age-groups

Conclusion: Although, households with younger index TB patients were more likely to attend screening, overall contact screening in urban slum was inadequate. National TB control programme and partners should strengthen household contact screening practice in urban area with special interventions for children.

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