ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
The Role of Youths in Within-Household Tuberculosis Transmission: A Household Contact Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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10 authors.
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Abstract
backgroundYouth aged 15-24 years are significantly impacted by tuberculosis globally. Their expanding social networks heighten exposure risks, potentially amplifying tuberculosis transmission, but their role in within-household transmission remains poorly understood.
methodsA household contact cohort study in Lima, Peru (2009-2012) enrolled individuals (>15 years) with incident tuberculosis (index patients) and their household contacts (HHCs), following them for 12 months. We evaluated whether the age of index patients and HHCs modified the risk of tuberculosis infection among HHCs. Study outcomes included: (1) prevalent tuberculosis infection among child contacts (<15 years) at enrollment and (2) incident tuberculosis infection among HHCs. Whole-genome sequencing of Mycobacterium tuberculosis (Mtb) isolates from index-HHC pairs assessed whether index patient age modified the likelihood of within-household transmission, defined as ≤12 single-nucleotide polymorphism differences.
resultsChild contacts of youth index patients had a lower risk of prevalent tuberculosis infection than those with adult index patients (aRR = 0.77; 95% CI: .67-.87). Among index-secondary patient pairs, 62% (26/42) of pairs with a youth index patient were genetically linked, compared to 72% (48/67) of pairs with an adult index patient (P = .3). Child and youth contacts had lower incident tuberculosis infection risk at 12-month follow-up compared to adult contacts (child vs adult: HR = 0.33; 95% CI: .28-.38; youth vs adult: HR = 0.61; 95% CI: .52-.71).
conclusionsYouth play a limited role in household tuberculosis transmission. Compared to adults, youth transmitted less TB as index patients and were less likely to be infected as HHCs. Research should explore youth social interactions and community-based transmission to inform targeted prevention strategies.
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