Tuberculosis infection among close contacts of patients with pulmonary tuberculosis in China: a population-based, multicentered study

Objectives: Limited information is currently available on the prevalence of and risk factors for tuberculosis infection (TBI) among close contacts of patients with pulmonary TB (PTB) in China. In this study, we estimated the burden of TBI among close contacts using QuantiFERON-TB Gold In-Tube assay (QFT) and identified factors associated with TB transmission among this high-risk population. Methods: From January 1, 2018 to August 31, 2020, we identified laboratory-confirmed patients with PTB from a population-based, multicentered, cluster-randomized control trial for tuberculosis preventive treatment. Close contacts of these patients were identified, interviewed, and tested using the QFT assay. We estimated TBI prevalence and calculated ORs and 95% CIs for TBI risk factors. Results: A total of 3138 index cases and 8117 close contacts were identified. Of these contacts, 36 had PTB (a prevalence of 443.51 cases/100 000 population). Among the remaining 7986 close contacts; 3124 (39.12%) reported a positive QFT result. QFT positivity was significantly associated with older age (adjusted OR, 1.77; [95% CI, 1.27-2.47], 2.20; [95% CI, 1.59-3.05], and 2.74; [95% CI, 1.96-3.82]) for age groups: 35-44, 45-54, and 55-64, respectively) when compared with a younger age group: 5-14; longer contact duration (adjusted OR, 1.44; 95% CI, 1.22-1.69); and sharing of a bedroom (adjusted OR, 1.39; 95% CI, 1.18-1.65). Discussion: Our findings indicate a high TBI burden among the close contacts of PTB. The results also highlighted that contact tracing and investigation for TBI are necessary and beneficial, particularly for those who are older, have had a longer contact duration, and share a bedroom. Canyou Zhang, Clin Microbiol Infect 2024;30:1176 (c) 2024 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).