Assessment of 16-year retrospective cohort study of factors associated with non-compliance with a tuberculosis contact tracing programme at a Spanish hospital.

RATIONALE, AIMS, AND OBJECTIVE: Contact tracing and screening is an essential strategy in tuberculosis (TB) control. Our aim is to assess factors associated with the degree of compliance with the main recommendations made to contacts of TB cases as part of the contact tracing programme, and to identify factors associated with non-compliance.

METHODS: We conducted a retrospective cohort study to assess the TB contact tracing programme at a Spanish hospital over the period 1998-2013.

RESULTS: A total 2269 contacts were identified corresponding to 644 active TB index cases, and initial screening indicated that 3.2% had active TB and 41.3% had latent TB infection (LTBI). Compliance with the recommendation for primary chemoprophylaxis increased significantly over the study period, rising from 76.5% in the period 1998 to 2002 to 82.7% in the period 2010 to 2013. A similar significant increase was also observed for latent tuberculosis infection treatment (46.1% in the first period to 68.0% in the latter period). Factors that were significantly associated with non-compliance with the recommendations were: being of foreign origin, alcoholism, being recommended latent tuberculosis infection treatment, repeating the tuberculin skin test at 3 months, a smear-positive index case, and an index case aged under 35 years old.

CONCLUSIONS: Although compliance levels have improved over the years, it remains necessary to adopt strategies that target contacts in groups identified as being at risk of non-compliance.