CONTACT TRACINGawacc.org/2014/ppt2015/CAPRISA Presentations/CONTACT...Coastlands Hotel : Durban...
Transcript of CONTACT TRACINGawacc.org/2014/ppt2015/CAPRISA Presentations/CONTACT...Coastlands Hotel : Durban...
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CONTACT TRACING
MDR WORKSHOP : EThekwini District
Coastlands Hotel : Durban
18.09. 2015
Z.V Radebe – KZN TBCP
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Outline
• Why contact tracing
• How
• Surveillance results
• Conclusion
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MMWR – March 2005
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• The main purpose is to prevent the spread of
DRTB in the community.
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Household surveillance of MDR/XDR
• 1st visit is conducted immediately after diagnosis of
index case
• Initially piloted in COSH and contacts were followed
twice over 2 years(Results available)
• Rolled out to the whole district in 2007 according to
WHO guidelines with the support of Italian
Cooperation.
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METHOD
• After diagnosis of MDR/XDR case Household file with all contacts is opened by the tracer / injection team.
• Each index case household is mapped.
• Contacts are screened for the first time.
• Sputa for AFB and culture is taken from contacts.
• Suspected cases who cannot produce sputum with signs and symptoms are referred to hospital for X-ray.
• All contacts are offered VCT at a household level.
• Data for the household is documented ( health, social, etc.).
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METHOD continued…
• Monteux test is done in children 5 yrs. and under.
• All children with positive Monteux , signs and symptoms of TB are sent for chest x-ray and VCT at hospital.
• The information is captured at the decentralized site.
• The list of households due for follow up at a specific Quarter is
sent out to sub-districts by the decentralized site as reminder.
• Sub districts follow up contacts and record findings on
household files every six months for 2 years
• Data is analyzed and report is compiled Quarterly/yearly.
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What else is done during household
visit• Education on TB/HIV
• Education on IPC(Ventilation, cough hygiene, use of
mask etc.)
• What to do if there is anyone with signs and
symptoms of TB
• Referral to other departments e.g SASSA, Home
affairs
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MDR Surveillance
2008 2009 2010
No HH visited 49 139 110
Contacts
Screened
296 895 609
Sputa collected 148 257 94
Monteux Test
done
26 44 15
AFB Positive 2 1 2
Culture Positive 2 2 2
MDR Diagnosed 1 0 0
XDR Diagnosed 0 0 0
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Results of contact tracing from Q1/09 to Q3/09.
1st visit 2nd visit 3rd visit 4th visit
Contacts
screened
1846 1334 930 127
TB 9 = 0.5% 8 =0.6% 0 0
MDR 12 = 0.7% 0 0 0
XDR 16 = 0.9% 1= 0.07% 0 0
Total Pos 37 = 2% 9(0.67) =1% 0 0
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Conclusion• Early tracing of household contacts is essential and
leads to:
• Decrease in transmission of MDR
• Decrease in death rate (MDR survival rate)
• Community awareness on importance of IPC in the
household(one to one education is given on IPC –
KAP study)
• Study conducted by MRC- KZN shows decrease in
XDR incidence at UMzinyathi but other districts
show increase!
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Change in incidence of XDR-TB in KwaZulu-Natal
province, South Africa, 2007 to 2010–
122007(MRC)
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Change in incidence of XDR-TB in KwaZulu-Natal
province, South Africa, 2007 to 2010–12
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The end
• Siyabonga
•Thank you