Prevalence of tuberculosis in adolescents, western Kenya: implications for control programs

Videlis Nduba; Anna H Van't Hoog; Ellen Mitchell; Peter Onyango; Kayla Laserson; Martien Borgdorff

doi:10.1016/j.ijid.2015.03.008

Prevalence of tuberculosis in adolescents, western Kenya: implications for control programs

Int J Infect Dis. 2015 Jun:35:11-7. doi: 10.1016/j.ijid.2015.03.008. Epub 2015 Mar 12.

Authors

Videlis Nduba¹, Anna H Van't Hoog², Ellen Mitchell³, Peter Onyango⁴, Kayla Laserson⁵, Martien Borgdorff⁶

Affiliations

¹ Kenya Medical Research Institute (KEMRI)/CGHR Research and Public Health Collaboration, TB Research Branch, PO Box 1578, Kisumu, Kenya; Academic Medical Centre of the University of Amsterdam, Netherlands; Kenya Medical Research Institute, Centre for Respiratory Diseases Research (CRDR), Nairobi, Kenya. Electronic address: vnduba@kemricdc.org.
² Kenya Medical Research Institute (KEMRI)/CGHR Research and Public Health Collaboration, TB Research Branch, PO Box 1578, Kisumu, Kenya; Academic Medical Centre of the University of Amsterdam, Netherlands; Amsterdam Institute for Global Health and Development, University of Amsterdam, Netherlands.
³ Academic Medical Centre of the University of Amsterdam, Netherlands; KNCV Tuberculosis Foundation, Netherlands.
⁴ Kenya Medical Research Institute (KEMRI)/CGHR Research and Public Health Collaboration, TB Research Branch, PO Box 1578, Kisumu, Kenya.
⁵ Kenya Medical Research Institute (KEMRI)/CGHR Research and Public Health Collaboration, TB Research Branch, PO Box 1578, Kisumu, Kenya; Center for Global Health, CDC Atlanta, Atlanta, Georgia, USA.
⁶ Kenya Medical Research Institute (KEMRI)/CGHR Research and Public Health Collaboration, TB Research Branch, PO Box 1578, Kisumu, Kenya; Academic Medical Centre of the University of Amsterdam, Netherlands; Center for Global Health, CDC Atlanta, Atlanta, Georgia, USA.

PMID: 25770911
DOI: 10.1016/j.ijid.2015.03.008

Abstract

Objective: The aim of this study was to determine the prevalence of tuberculosis (TB) in adolescents in western Kenya.

Methods: A cohort study of 5004 adolescents aged 12-18 years was conducted. Adolescents were screened for prevalent TB using clinical criteria, history of TB contact, and a Mantoux test. Cases of suspected TB were investigated through two sputum examinations (microscopy and liquid culture) and chest radiography.

Results: Out of 5004 adolescents enrolled, 1960 (39.2%) were identified with suspected TB, including 1544 with a positive Mantoux (prevalence 1544/4808, 32.1%), 515 with symptoms suggestive of TB (10.3%), and 144 (2.9%) with household TB contact. Sixteen culture-confirmed (definite) and 18 probable pulmonary TB (PTB) cases were identified, reflecting a prevalence estimate of 3.2/1000 (definite) and 6.8/1000 all PTB, respectively. Only one smear-positive case was detected. The case notification rate among 12-18-year-old adolescents for all TB was 101/100000, yielding a patient diagnostic rate of 0.13 (95% confidence interval 0.03-3.7) cases detected per person-year for all TB.

Conclusion: The prevalence of PTB among adolescents is high, with the majority of cases not detected routinely. Innovative active case finding including the wider use of Xpert MTB/RIF is needed to detect smear-negative TB among adolescents.

Keywords: Diagnosis; Epidemiology; Mantoux; Pulmonary; Tuberculosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Cohort Studies
Cross-Sectional Studies
Female
Humans
Infection Control
Kenya / epidemiology
Male
Prevalence
Tuberculosis, Pulmonary / diagnosis
Tuberculosis, Pulmonary / epidemiology*
Tuberculosis, Pulmonary / prevention & control