ArticleAnnals of medicine2026
Tuberculosis disease and infection among household contacts of bacteriologically confirmed vs unconfirmed tuberculosis in Cambodia: considerations for optimising contact investigation and preventive treatment.
Article in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aimed to describe the yield of tuberculosis (TB) disease among household contacts (HHC) of individuals with bacteriologically confirmed and unconfirmed pulmonary TB, to estimate the prevalence of TB infection using Interferon Gamma Release Assay (IGRA), and to identify factors associated with IGRA positivity.
methodsWe conducted a pragmatic, cross-sectional study in five operational districts between February 2023 and April 2024. HHC of persons with pulmonary TB in the preceding two years were screened for TB. Among eligible contacts (aged ≥5 years and HIV negative) at two purposively selected sites (one urban and one rural), blood samples were collected for IGRA using QuantiFERON
resultsAmong 864 HHC, 26 were diagnosed with TB disease: 2.7 per 100 (95% CI 1.4-4.6) among contacts of bacteriologically confirmed TB and 3.4 per 100 (95% CI 1.9-5.6) among contacts of bacteriologically unconfirmed TB. More than half were asymptomatic (37.5% bacteriologically confirmed, 66.7% bacteriologically unconfirmed). Of 453 valid IGRA results, 21.2% (95% CI 17.5-25.2) were positive. IGRA positivity was associated with older age, urban residence, and being contacts of bacteriologically confirmed TB.
conclusionIn these selected programmatic settings, limiting contact investigation to bacteriologically confirmed TB and relying on symptom screening may result in missed cases. Without infection testing, most HHC offered TPT may not require it, while others with asymptomatic TB disease may inappropriately receive preventive treatment.
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