@article {Sinfield:September 2006:0272-4936:205,
	author = "Sinfield, R.",
	author = "Nyirenda, M.",
	author = "Haves, S.",
	author = "Molyneux, E.M.",
	author = "Graham, S.M.",
	title = "Risk factors for TB infection and disease in young childhood contacts in Malawi",
	journal = "Annals of Tropical Paediatrics: International Child Health",
	volume = "26",
	year = "September 2006",
	abstract = "<I>Background</I>: Screening of children in household contact with smear-positive tuberculosis (TB) is universally recommended but seldom practiced in resource-poor settings. It has huge potential to reduce the burden of TB disease in children, particularly if streamlined to focus on those at greatest risk.<P></P><I>Aims</I>: To assess the prevalence of infection and disease amongst children aged &#8804; 5 yrs in household contact with smear-positive TB. To identify which source case characteristics are risk factors for infection.<P></P><I>Methods</I>: A prospective, hospital-based audit was conducted over a 17-mth period in Southern Malawi. Smear-positive adults were identified and encouraged to bring their children to the outpatient clinic, in accordance with the national TB programme guidelines. Full assessment was performed, including tuberculin skin test.<P></P><I>Results</I>: 195 children aged &#8804; 5 yrs who were contacts of 161 source cases were assessed. Prevalences of TB infection and disease were high (45% and 23%, respectively). The likelihood of a child being infected was significantly greater with increasing smear-positivity of the source case, and also if the source case were female (OR 2.25, 95% CI 1.19-4.27, <I>p</I>=0.01).<P></P><I>Conclusions</I>: The high prevalence of TB infection and disease in child contacts attending this hospital-based clinic supports the current policy of contact-screening in Malawi. However, community-based studies are needed to provide a more accurate assessment of prevalence and risks for child contacts.",
	pages = "205-213(9)",
	url = "http://www.ingentaconnect.com/content/maney/atp/2006/00000026/00000003/art00006"
	doi = "doi:10.1179/146532806X120291"
}