Weepi

Latent tuberculosis infection prevalence in children with household tuberculosis contact in the city of Kyiv and Kyiv region (oblast), Ukraine

Grantee

NGO "Infection Control in Ukraine", Ukraine

Main applicant and principal investigator

Mariia Dolynska, Medical Director, NGO "Infection Control in Ukraine"

Deputy applicant

Andrii Aleksandrin, Head, NGO "Infection Control in Ukraine"

Collaborators 

  1. Robert C. Horsburgh, MD, Professor of Epidemiology, Biostatistics, Global Health and Medicine, Boston University, USA
  2. Helen E. Jenkins, Ph.D., Assistant Professor of Biostatistics, School of Public Health, Boston University, USA
  3. Natasha R. Rybak MD, Medical Director, RISE Tuberculosis Clinic, the Miriam Hospital; Assistant Professor of Medicine, Clinician Educator, Department of Medicine, Division of Infectious Diseases, Warren Alpert Medical School of Brown University, Rhode Island, USA
  4. Alexander Trusov, MD, Ph.D., Senior Technical Advisor of NGO “MAD Consulting”, Kazakhstan

Background

Prevention of latent tuberculosis infection (LTBI) progression to TB disease is critical for reducing the TB burden and achieving the End TB Strategy targets set for 2030 and 2035. Currently, there are no reliable data on the LTBI rate in Ukraine and no published data on the relative risk (RR) of LTBI in children with household contacts compared with children in the community. National LTBI screening is based on tuberculin skin tests (TST) resulting in a high proportion of false-positive results in a population where 95% receive BCG-vaccination at birth. However, these data are necessary to plan interventions related to LTBI treatment.

Objective

To assess the LTBI positivity rate in children exposed to TB contacts and estimate the number of children needing LTBI treatment per TB index case. We hypothesize that we will find a large number of TB infected children in TB exposed households, but that we will find a substantial number of TB infected children in control (non-TB exposed) households too.

Methods

150 TB household exposed children, identified through contact tracing among TB patients in one city district of Kyiv, and 150 non-household exposed children, recruited through a kindergarten, a primary and a lower secondary school in the same district, will be enrolled into a case-control study. LTBI positivity will be assessed using Interferon Gamma Release Assay (IGRA) testing.

Output / impact

The study will, for the first time in Ukraine, provide estimates of LTBI prevalence among children with household contacts, and preliminary data on LTBI in the general children population. These data can help estimate and forecast the need for LTBI treatment in different population groups and, potentially, help improve the management of LTBI screening and treatment in Ukraine.