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Home / Public Health Action, Volume 11, Number 2

Open Access TB contact tracing for young children: an Australian cascade of care review

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OBJECTIVE: To evaluate care cascades for programmatic active case finding and latent TB infection (LTBI) management in young child TB contacts (aged <5 years) in Victoria, Australia.

DESIGN: This was a retrospective review of public health surveillance data to identify contacts of all pulmonary TB cases notified from 2016 to 2019.

RESULTS: Contact tracing identified 574 young child contacts of 251 pulmonary TB cases. Active TB was found in 28 (4.9%) contacts, none of whom had previously received bacille Calmette-GuĂ©rin vaccination, and 529 were tested for TB infection using the tuberculin skin test (TST). The overall TST positivity was 15.3% (95% CI 0.1–0.2). Among the 574 children, 150 (26.1%) were close contacts of sputum smear-positive cases and 25 (16.7%) of these were not referred to TB clinics. Of the 125 referred, 81 were considered to have LTBI, 79 agreed to commence TB preventive treatment (TPT) and 71 (89.9%) completed TPT. Following completion of TPT, no child was subsequently diagnosed with active TB.

CONCLUSION: There was a high yield from active case finding and uptake of TPT. Notable losses in the cascade of care occurred around referral to tertiary clinics, but high treatment completion rates and good outcomes were found in those prescribed treatment.

Keywords: active case finding; child; contact tracing; preventive therapy; tuberculosis

Document Type: Research Article

Affiliations: 1: Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC, Australia, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia 2: Health Protection Branch, Department of Health and Human Services, Melbourne, VIC, Australia 3: Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC, Australia 4: Department of General Medicine, Royal Children’s Hospital, Parkville, VIC, Australia, Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia 5: Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia, Department of Respiratory Medicine, Royal Children’s Hospital, Parkville, VIC, Australia 6: Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC, Australia, Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia

Publication date: 21 June 2021

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  • Public Health Action (PHA), The Union's quarterly Open Access journal, welcomes the submission of articles on operational research. It publishes high-quality scientific research on health services, providing new knowledge on how to improve access, equity, quality and efficiency of health systems and services.

    The Editors will consider any manuscript reporting original research on quality improvements, cost-benefit analysis, legislation, training and capacity building, with a focus on all relevant areas of public health (e.g. infection control, nutrition, TB, HIV, vaccines, smoking, COVID-19, microbial resistance, outbreaks etc).

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