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Aim: To assess the risk of tuberculosis (infection and disease) in children less than 15 years’ old who are household contacts of pulmonary tuberculosis patients in three Colombian cities (Medellín, Cali, and Popayán).




Methods: A cohort of 1,040 children household contacts of 380 adults with smear-positive pulmonary tuberculosis was followed up for 24 months. Study period 2005-2009.




Results: Tuberculin skin test was positive (≥10 mm) in 43.7% (95% CI: 39.2-48.2). Tuberculin skin test positivity was associated with age 10-14 years (Prevalence Ratio -PR= 1.43, 95% CI: 1.1-1.9), having a BCG vaccine scar (PR= 1.52, 95% CI: 1.1-2.1), underweight, closer proximity to the index case and exposure time >3 months. The annual risk of infection (tuberculin skin test induration increase of 6 mm or more per year) was 17% (95% CI: 11.8-22.2) and was associated with a bacillary load of the adult index case (Relative Risk -RR= 2.12, 95% CI: 1.0-4.3). The incidence rate of active tuberculosis was 12.4 cases per 1,000 persons-year. Children <5 years without BCG vaccine scar had a greater risk of developing active disease (Hazard Ratio -HR= 6.00, 95% CI: 1.3-28.3) than those with scar (HR= 1.33, 95% CI: 0.5-3.4). The risk of developing active tuberculosis augmented along with the increase from initial tuberculin skin test (tuberculin skin test 5-9 mm HR= 8.55, 95% CI: 2.5-29.2; tuberculin skin test ≥10 mm HR= 8.16, 95% CI: 2.0-32.9).




Conclusions: There is a need for prompt interruption of adult-to-children tuberculosis transmission within households. Conducting proper contact investigation and offering chemoprophylaxis to infected children could reduce tuberculosis transmission.


Dione Benjumea Bedoya, 1 Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia. Corporación Universitaria Remington, Grupo de Investigación en Salud Familiar y Comunitaria, Medellín, Colombia

orcid_id28.png https://orcid.org/0000-0002-4004-2219

Diana M Marín, 1 Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia.

orcid_id28.png https://orcid.org/0000-0002-4715-8388

Jaime Robledo, Universidad Pontificia Bolivariana, Medellín, Colombia.

Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia

orcid_id28.pnghttps://orcid.org/0000-0002-5731-1905 

Luis F Barrera, Universidad de Antioquia, Grupo de Inmunología Celular e Inmunogenética (GICIG), Medellín, Colombia.

orcid_id28.png https://orcid.org/0000-0002-9684-726X 

Lucelly López, 1 Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia. 2 Universidad Pontificia Bolivariana, Medellín, Colombia

orcid_id29.png https://orcid.org/0000-0002-1534-520X

Helena del Corral, Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia.

orcid_id29.png https://orcid.org/0000-0003-2581-0758

Beatriz E Ferro, 1 Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia. 2 Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia.

orcid_id29.png https://orcid.org/0000-0001-6045-1610

Sonia L Villegas, 1 Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia. 2 Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health.

orcid_id29.png https://orcid.org/0000-0001-5053-0091

María Lilia Díaz, Universidad del Cauca, Grupo de Inmunología y Enfermedades Infecciosas, Popayán, Colombia

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Carlos A Rojas, Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia.

orcid_id30.png https://orcid.org/0000-0002-1906-6048

Luis F García, Universidad de Antioquia, Grupo de Inmunología Celular e Inmunogenética (GICIG), Medellín, Colombia.

orcid_id30.png https://orcid.org/0000-0002-5343-0050

María P Arbeláez, Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia.

orcid_id30.png https://orcid.org/0000-0003-2435-4658

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Received 2020-01-29
Accepted 2020-03-01
Published 2024-05-20