Evaluation of School-Based Tuberculosis Screening Results After Index Case (Both Intellectual Disability and Cavitary Pulmonary Tuberculosis)

Abstract

Objective: Tuberculosis is an important public health problem. Tuberculosis prevalence is high in low-income countries. It is contagious, and therefore a risk for people in public living areas. It is contagious, and therefore a risk for people in public areas. Also, people with intellectual disability stay in the same public areas. Therefore, they are also at risk. The aim of our study was to investigate the contact of persons in the same center with an index case. Materials and methods: Contact investigation was conducted in a training and rehabilitation center. Tuberculosis-specific parameters were measured from the patients. Results: All contacts (n=39) were male. Fifteen contacts were offered follow-up without medication. Fifteen contacts were given medication for prophylaxis. Latent tuberculosis was detected in 8 patients. Possible tuberculosis was detected in one patient. Contagion of tuberculosis from the index case to his roommates measured 16.6%. Tuberculosis contagion from the patient with possible tuberculosis to his roommates measured 37.5%. Patients with latent tuberculosis and possible tuberculosis were medicated according to international criteria. Conclusion: People with intellectual disability do not fully define the symptoms of the disease. Therefore, the prognosis may be made when the disease is diagnosed by a health professional. Also, some tests may not be performed because communication is not possible. For this reason, clinicians should be more careful in screening people with intellectual disability for TB. Also, the fight against tuberculosis should be continued without interruption.

Keywords

• Contact screening
• intellectual disability
• school-based tuberculosis
• cavitary pulmonary tuberculosis

Zihinsel Engellilik ve Kaviter Akciğer Tüberküloza Sahip İndex Vaka Sonrası Okul Temelli Tüberküloz Tarama Sonuçlarının Değerlendirilmesi

Abstract

Amaç: Tüberküloz önemli bir halk sağlığı sorunudur. Düşük gelirli ülkelerde tüberküloz prevalansı yüksektir. Bulaşıcıdır, bu nedenle toplu yaşam alanlarındaki insanlar için bir risktir. Ayrıca zihinsel engelli insanlar aynı toplu yaşam alanlarında kalırlar. Bu nedenle, onlar da risk altındadır. Çalışmamızın amacı aynı merkezde kalan indeks vaka ile temaslı çocukların tarama sonuçlarının paylaşılması ve temaslarını incelemektir. Gereç ve Yöntem: Temas araştırması bir Zihinsel Engelliler Rehabilitasyon ve Eğitim Merkezinde yapılmıştır. Hastalarda tüberküloza özgü parametreler değerlendirildi. Bulgular: Otuz dokuz hastanın tamamı erkekti (%100). On beş kişi ilaçsız takip edildi. On beş kişiye profilaksi verildi. Sekiz hastada latent tüberküloz tespit edildi. Bir hastada olası tüberküloz tespit edildi. İndeks vakadan oda arkadaşlarına tüberküloz iletimi %16.6 iken olası tüberküloz hastasından oda arkadaşlarına tüberküloz iletimi %37.5 olarak saptandı. Latent tüberküloz ve olası tüberküloz tanısı alan hastalar, uluslararası kriterlere göre tedavi edilmiştir. Sonuç: Zihinsel engelli kişiler, hastalığın semptomlarını tam olarak tanımlayamazlar. Bu nedenle, hastalık bir sağlık profesyoneli tarafından teşhis edildiğinde hastalık ilerleyebilir. Ayrıca, iletişim mümkün olmadığından bazı testler gerçekleştirilemeyebilir. Bu nedenle, klinisyenler zihinsel engeli olan kişilerin taramasında daha dikkatli olmalıdır. Ayrıca tüberküloz ile mücadeleye ara vermeden devam edilmelidir.

Keywords

• Temas taraması
• zihinsel engellilik
• okul temelli tüberküloz
• kaviter akciğer tüberkülozu

References

1. 1-Raviglione MC, Snider DE, Kochi A. Global epidemiology of tuberculosis: morbidity and mortality of a worldwide epidemic. JAMA 1995;273(3):220-6.
2. 2- Jenkins HE, Tolman AW, Yuen CM, Parr JB, Keshavjee S, Pérez-Vélez CM, et.al. Incidence of multidrug-resistant tuberculosis disease in children: systematic review and global estimates. Lancet 2014;383(9928):1572-9.
3. 3- Centers for Disease Control and Prevention. Estimates for future global tuberculosis and mortality. JAMA 1994; 271:739–40.
4. 4-Singh M, Mynak ML, Kumar L, Mathew JL, Jindal SK. Prevalence and risk factors for transmission of infection among children in household contact with adults having pulmonary tuberculosis. Arch Dis Child 2005;90(6):624-8.
5. 5-Cooper SA, Smiley E, Morrison J, Williamson A, Allan L. Mental ill-health in adults with intellectual disabilities: prevalence and associated factors. Br J Psychiatry 2007;190(1):27-35.
6. 6-Harris JC. Intellectual disability: Understanding its development, causes, classification, evaluation, and treatment. England, Oxford University Press. 2006:42-5.
7. 7-King N, Lancaster N, Wynne G, Nettleton N, Davis R. Cognitive-behavioral anger management training for adults with mild intellectual disability. Scand J Behav Ther 1999;28(1):19-22.
8. 8- Sağlık Bakanlığı, Tüberküloz Tanı ve Tedavi Rehberi, Akdağ R. (eds), Ankara, 2011:71-8.

9. 9- World Health Organization. Recommendations for investigating contacts of persons with infectious tuberculosis in low-and middleincome countries, Genova, 2012 (No. WHO/ HTM/TB/2012.9)
10. 10- Mazure GH, Jereb J, LoBue P, Iademarco MF, Vernon A. Guidelines for Using the QuantiFERON®-TB G Test for Detecting Mycobacterium tuberculosis Infection, United States.MMWR 2005;15:49-55.
11. 11- World Health Organization. Global Tuberculosis Report, 20th Edition, Geneva, 2015, ISBN 9789241565059.
12. 12-Chiang SS, Starke JR. Mycobacterium Tuberculosis. In: Long SS, Prober CG, Fischer M (eds). Principles and Practice of Pediatric Infectious Disease. 5th ed. Philadelphia: Elsevier, 2018:4026-81.
13. 13-Kabasakal E, Yıldırım A, Mutlu M, Baykal F. Kara F (eds). Türkiye’de Verem Savaşı 2018 Raporu. Ankara, 2018:11-13.
14. 14-Schepisi MS, Motta I, Dore S, Costa C, Satgiu G, Giordi E. Tuberculosis transmission among children and adolescents in schools and other congregate settings: a systemic review. New Microbiologica 2018;41;(4):282-90.
15. 15- Mandalakas AM, Kirchner HL, Lombard C, Walzl G, Grewal HM, Gie RP, Hesseling AC. Wellquantified tuberculosis exposure is a reliable surrogate measure of tuberculosis infection. Int J Tuberc Lung Dis 2012;16(8):1033-9.
16. 16- Roberts JR, Mason BW, Paranjothy S, Palmer SR. The transmission of tuberculosis in schools involving children 3 to 11 years of age. Pediatr Infect Dis J 2012; 31:82-4.
17. 17- Molicotti P, Bua A, Mela G, Olmeo P, Delogu R, Ortu S, et.al. Performance of QuantiFERON-TB testing in a tuberculosis outbreak at a primary school. J Pediatr 2008;152(4):585-6.
18. 18- Paranjothy S, Eisenhut M, Lilley M, Bracebridge S, Abubakar I, Mulla R,. et al. Extensive transmission of Mycobacterium tuberculosis from 9 year old child with pulmonary tuberculosis and negative sputum smear. BMJ 2008:28;337.a1184.
19. 19- Kara S, Büyükvanlı F, Öngel K, Yıldırım Baş F, Türker Y. Akciğer Tüberkülozlu Servis Şöförü İle Temas Sonrasında Bir İlköğretim Okulunda Yapılan Tarama Sonuçları. 2.Trakya Aile Hekimliği Kongresi, Turkey, 2012.
20. 20- Kim D, Lee S, Kang SH, Park MS, Yoo SY, Jeon TY et al. A contact investigation after exposure to a child with disseminated tuberculosis mimicking inflammatory bowel disease. Korean J Pediatr 2018;61(11):366.
21. 21- Ustero PA, Kay AW, Ngo K, Golin R, Tsabedze B, Mzileni B et al. School and household tuberculosis contact investigations in Swaziland: active TB case finding in a high HIV/TB burden setting. PloS one 2017;12(6):e0178873.
22. 22-Lutpiatina L, Wahidah W, Nurhilaliah N, Rakhmina D, Rifqoh R. Sputum Quality of The Anytime and Outset for Examination Acid- Resistance Bacilli. MLTJ 2018;4(1):26-9.