• Household screening and multidrug-resistant tuberculosis

      Cox, H; van Cutsem, G; Burnet Institute for Medical Research and Public Health, Centre for Population Health, Melbourne, Australia; Médecins Sans Frontières, Cape Town, South Africa (2010-12-09)
      Of the estimated half a million people who develop multidrug resistant (MDR) tuberculosis each year, less than 7% are diagnosed and only 1 in 5 of these have access to eff ective treatment.1 To control this epidemic, dramatically increased efforts are required to scale up case detection and treatment provision. In The Lancet, Mercedes Becerra and colleagues2 report the yield of additional MDR tuberculosis diagnoses that are found by screening household contacts of index cases in Lima, Peru. This study—the largest of its kind to date—found that more than 2% of 4503 household contacts had active tuberculosis at the time the index case was diagnosed. Incident tuberculosis was also found at a rate of 1624 cases per 100 000 person-years over 4 years follow-up. These results support recommendations for active screening of household contacts of people with MDR tuberculosis,3 and provide valuable lessons for other programmes striving to improve case detection and to reduce community transmission of MDR tuberculosis.
    • A large outbreak of Hepatitis E virus genotype 1 infection in an urban setting in Chad likely linked to household level transmission factors, 2016-2017.

      Spina, A; Lenglet, A; Beversluis, D; de Jong, M; Vernier, L; Spencer, C; Andayi, F; Kamau, C; Vollmer, S; Hogema, B; et al. (Public Library of Science, 2017-11-27)
      In September 2016, three acutely jaundiced (AJS) pregnant women were admitted to Am Timan Hospital, eastern Chad. We described the outbreak and conducted a case test-negative study to identify risk factors for this genotype of HEV in an acute outbreak setting.