Rates of Tuberculosis Transmission to Children and Adolescents in a Community with a High Prevalence of HIV Infection among Adults

Abstract

Background. Tuberculin skin test surveys are routinely used to test for tuberculosis (TB) infection in communities, but there are few data from tuberculin skin test surveys from countries in which both TB and human immunodeficiency virus (HIV) infection are prevalent. Methods. We conducted a tuberculin skin test survey among 831 school-going children aged 5–17 years in a community that was experiencing an increase in the prevalence of TB and HIV infection. Responses to purified protein derivative RT23 were measured 3 days after the test was administered to determine tuberculin skin test results. Results. The prevalence of tuberculin skin test results positive for TB (i.e., an induration Conclusions. The annual risk of infection is high in the community. It appears that HIV infection-associated TB is not a major influence on the annual risk of infection and that TB transmission from adults to children may be associated with a subset of TB cases in the community. An improved understanding of TB transmission patterns is urgently needed help the implementation of novel strategies for reducing the annual risk of infection in this setting.