Influence of the identification of contacts on the adherence of index tuberculosis cases to treatment in a high incidence country

Abstract

Background: Health professionals must interview index tuberculosis (TB) cases to identify and examine their contacts, because human interaction favors disease transmission. Revealing their contacts implies the disclosure of their health condition to close friends and family. The aim of this study was to evaluate the influence of the identification of contacts of TB index cases on the outcomes of TB treatment. Methods: This observational, cross-sectional, epidemiological study was conducted using data provided by SINAN-Net on subjects diagnosed with TB between 2008 and 2012 in Paraná, Brazil. The inclusion criteria were new cases of pulmonary TB in individuals older than 15 years. Results: A total of 9867 new cases of TB were identified. In total, 29% of adult cases did not have their contacts examined, and of these, 61.8% were smear-positive. The adults whose contacts were not examined underwent fewer tests and presented a lower cure rate and higher rates of treatment dropout and death. Conclusions: The detection of the contacts of index cases constitutes an epidemiological and public health strategy for the surveillance and control of TB. The health professionals who promote patient adherence to treatment and the involvement of their families in the fight against TB achieve better results regarding the identification of contacts of index cases, adherence to treatment, and cure. Keywords: Tuberculosis, Contact tracing, Infectious diseases, Epidemiological surveillanc