ArticleThe Lancet. Infectious diseases2024
Incidence and risk factors of tuberculosis among 420 854 household contacts of patients with tuberculosis in the 100 Million Brazilian Cohort (2004-18): a cohort study.
Article in The Lancet. Infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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19 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Record linkage in tuberculosis epidemiological surveillance in Brazil: systematic methodological literature review.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2026Pooled it
- Environmental Determinants of Tuberculosis in Low-Resource Settings: Heavy Metals, Healthcare Waste Management, and Drug-Resistant TB.Biological trace element research · 2026Review
- Long-term risk of death after tuberculosis diagnosis and treatment.Nature medicine · 2026Article
- Identification of discriminative plasma protein biomarkers for recent Mycobacterium tuberculosis infection: a pilot data‑independent acquisition mass spectrometry‑based proteomics study.BMC infectious diseases · 2026Article
- Projected Effects of Changing Global Tuberculosis Epidemiology on Mycobacterium tuberculosis Immunoreactivity Prevalence, 2024-2050.Emerging infectious diseases · 2026Article
- Tuberculosis prevention in children, adolescents, and pregnant and postpartum women in South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
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- Analysis of the clinical value and influencing factors of combined detection of tuberculosis-specific cytokines IFN-γ and IL-2 in the diagnosis of active tuberculosis in children and adolescents.European journal of medical research · 2025Article
- Epidemiological Analysis of Tuberculosis Transmission, Risk Factors, and Subclinical Tuberculosis Management in a High School Outbreak, South Korea.Open forum infectious diseases · 2025Article
- Effects of Kanamycin on Hearing and Vestibular Function in Multidrug-Resistant Tuberculosis Patients.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2025Article
- Tuberculosis and drug resistance in a region of Southern Italy among native and foreign-born populations: A twelve-year province-based study.Journal of clinical tuberculosis and other mycobacterial diseases · 2025Article
- The yield of tuberculosis contact investigation in São Paulo, Brazil: a community-based cross-sectional study.Epidemiology and infection · 2025Article
- Article
- Treatment completion and challenges in rolling out 12-dose weekly rifapentine plus isoniazid to prevent tuberculosis among people living with HIV and pediatric household contacts in Brazil.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2025Article
- Impact of strategic public health interventions to reduce tuberculosis incidence in Brazil: a Bayesian structural time-series scenario analysis.Lancet regional health. Americas · 2025Article
- In-home TB Testing Using GeneXpert Edge is Acceptable, Feasible, and Improves the Proportion of Symptomatic Household Contacts Tested for TB: A Proof-of-Concept Study.Open forum infectious diseases · 2024Article
- Evaluating social protection mitigation effects on HIV/AIDS and Tuberculosis through a mathematical modelling study.Scientific reports · 2024Article
- Tuberculosis contact tracing, Angola.Bulletin of the World Health Organization · 2024Article
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Authors and funding
10 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundAlthough household contacts of patients with tuberculosis are known to be particularly vulnerable to tuberculosis, the published evidence focused on this group at high risk within the low-income and middle-income country context remains sparse. Using nationwide data from Brazil, we aimed to estimate the incidence and investigate the socioeconomic and clinical determinants of tuberculosis in a cohort of contacts of tuberculosis patients.
methodsIn this cohort study, we linked individual socioeconomic and demographic data from the 100 Million Brazilian Cohort to mortality data and tuberculosis registries, identified contacts of tuberculosis index patients diagnosed from Jan 1, 2004 to Dec 31, 2018, and followed up the contacts until the contact's subsequent tuberculosis diagnosis, the contact's death, or Dec 31, 2018. We investigated factors associated with active tuberculosis using multilevel Poisson regressions, allowing for municipality-level and household-level random effects.
findingsWe studied 420 854 household contacts of 137 131 tuberculosis index patients. During the 15 years of follow-up (median 4·4 years [IQR 1·9-7·6]), we detected 8953 contacts with tuberculosis. The tuberculosis incidence among contacts was 427·8 per 100 000 person-years at risk (95% CI 419·1-436·8), 16-times higher than the incidence in the general population (26·2 [26·1-26·3]) and the risk was prolonged. Tuberculosis incidence was associated with the index patient being preschool aged (<5 years; adjusted risk ratio 4·15 [95% CI 3·26-5·28]) or having pulmonary tuberculosis (2·84 [2·55-3·17]).
interpretationThe high and sustained risk of tuberculosis among contacts reinforces the need to systematically expand and strengthen contact tracing and preventive treatment policies in Brazil in order to achieve national and international targets for tuberculosis elimination.
fundingWellcome Trust and Brazilian Ministry of Health.
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