Yield of contact investigations in households of patients with drug-resistant tuberculosis: systematic review and meta-analysis

Clin Infect Dis. 2014 Feb;58(3):381-91. doi: 10.1093/cid/cit643. Epub 2013 Sep 24.


Contact investigations among individuals living with drug-susceptible tuberculosis patients (source cases) have shown a high yield of tuberculosis disease and latent tuberculosis, but the yield of such investigations in households of drug-resistant tuberculosis source cases is unknown. In this systematic review and meta-analysis, we found 25 studies that evaluated a median of 111 (interquartile range, 21-302) household contacts of drug-resistant tuberculosis source cases. The pooled yield was 7.8% (95% CI, 5.6%-10.0%) for active tuberculosis and 47.2% (95% CI, 30.0%-61.4%) for latent tuberculosis, although there was significant statistical heterogeneity (P < .0001). More than 50% of secondary cases with drug susceptibility test results were concordant with those of the source case. Among studies that followed household members, the majority of secondary cases were detected within 1 year of the source case's diagnosis. Household contact investigation around drug-resistant tuberculosis patients is a high-yield intervention for detection of drug-resistant tuberculosis and prevention of ongoing transmission.

Keywords: contact; drug resistance; transmission; tuberculosis.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Review
  • Systematic Review

MeSH terms

  • Contact Tracing*
  • Family Characteristics*
  • Humans
  • Prevalence
  • Tuberculosis, Multidrug-Resistant / epidemiology*
  • Tuberculosis, Multidrug-Resistant / microbiology*
  • Tuberculosis, Multidrug-Resistant / transmission