Characteristics, management and contact tracing outcomes of TB cases notified before and after cohort review implementation
| Precohort review | Postcohort review | p Value* | |||
|---|---|---|---|---|---|
| n/N | % | n/N | % | ||
| Description of cases | |||||
| Patient demographics | |||||
| Male | 307/557 | 55.1 | 407/752 | 54.1 | 0.721 |
| Aged 20–39 years | 248/557 | 44.5 | 365/752 | 48.5 | 0.150 |
| Non-UK born | 409/541 | 75.6 | 586/742 | 79.0 | 0.152 |
| Recent migrant (<2 years) | 44/425 | 10.4 | 88/596 | 14.8 | 0.038 |
| Long-term resident (≥10 years) | 243/425 | 57.2 | 274/596 | 46.0 | <0.001 |
| Reported risk factor on LTBR† | 120/547 | 21.9 | 116/735 | 15.8 | 0.005 |
| Clinical characteristics | |||||
| Pulmonary | 328/557 | 58.9 | 394/752 | 52.4 | 0.020 |
| Sputum | 111/328 | 52.3 | 139/394 | 52.1 | 0.975 |
| Culture confirmed | 278/557 | 49.9 | 418/752 | 55.6 | 0.042 |
| Any drug resistance | 39/278 | 14 | 54/418 | 12.9 | 0.673 |
| MDR | 7/274 | 2.6 | 9/417 | 2.2 | 0.735 |
| HIV test | |||||
| Offered | 511/557 | 91.7 | 694/752 | 92.3 | 0.718 |
| Performed | 510/557 | 91.6 | 687/752 | 91.4 | 0.895 |
| Case management and contact tracing outcomes | |||||
| Treatment outcome at 12 months‡ | |||||
| Completed | 480/549 | 87.4 | 637/737 | 86.4 | 0.599 |
| Still on treatment | 23/549 | 4.2 | 44/737 | 6.0 | 0.155 |
| Died | 24/549 | 4.4 | 20/737 | 2.7 | 0.106 |
| Lost to follow-up | 12/549 | 2.2 | 25/737 | 3.4 | 0.201 |
| lost to follow-up overseas | 4/549 | 0.7 | 16/737 | 2.2 | 0.039 |
| excluding those lost to follow-up overseas | 8/549 | 1.5 | 9/737 | 1.2 | 0.714 |
| Treatment stopped | 10/549 | 1.8 | 11/737 | 1.5 | 0.645 |
| DOT§ | |||||
| Required DOT | 62/380 | 16.3 | 145/680 | 21.3 | 0.049 |
| Required DOT (with identified risk factor†) | 42/110 | 38.2 | 79/134 | 59.0 | 0.001 |
| Offered DOT | 58/62 | 93.6 | 135/145 | 93.1 | 0.907 |
| Offered DOT (with identified risk factor†) | 41/42 | 97.6 | 73/79 | 92.4 | 0.242 |
| Received DOT | 52/62 | 83.9 | 91/145 | 62.8 | 0.003 |
| Received DOT (with identified risk factor†) | 38/42 | 90.5 | 56/79 | 70.9 | 0.014 |
| Refused DOT | 6/62 | 9.7 | 44/145 | 30.3 | 0.001 |
| Refused DOT (with identified risk factor†) | 3/42 | 7.1 | 17/79 | 21.5 | 0.043 |
| One or more contacts identified | |||||
| All cases | 430/557 | 77.2 | 646/752 | 85.9 | <0.001 |
| Pulmonary | 257/328 | 78.4 | 345/394 | 87.6 | 0.001 |
| Sputum smear positive | 102/111 | 91.9 | 132/139 | 95.0 | 0.324 |
| Three or more contacts identified | |||||
| All cases | 282/557 | 50.6 | 428/752 | 56.9 | 0.024 |
| Pulmonary | 179/328 | 54.6 | 252/394 | 64.0 | 0.010 |
| Sputum smear positive | 82/111 | 73.9 | 115/139 | 82.7 | 0.089 |
| Five or more contacts identified | |||||
| All cases | 160/557 | 28.7 | 233/752 | 30.1 | 0.378 |
| Pulmonary | 107/328 | 32.6 | 144/394 | 36.6 | 0.270 |
| Sputum smear positive | 61/111 | 55.0 | 75/139 | 54.0 | 0.875 |
| Contacts assessed | |||||
| All cases | 1312/1777 | 73.8 | 2134/2644 | 80.7 | <0.001 |
| Pulmonary | 856/1162 | 73.7 | 1301/1594 | 81.6 | <0.001 |
| Sputum smear positive | 433/559 | 77.5 | 621/735 | 84.5 | 0.001 |
*Bold denotes significant after using Bonferroni correction (p<0.00125).
†Reported history of homelessness, imprisonment, drug or alcohol misuse, or mental health issues.
‡Excluding cases with known rifampicin resistance.
§Excluding children aged 15 years or younger.
DOT, directly observed therapy; TB, tuberculosis.