HHC in TB stands for Household Contacts of individuals with pulmonary tuberculosis (PTB). These individuals are at significantly higher risk of acquiring both TB infection (TBI) and TB disease (TBD) compared to the general population.
Why are Household Contacts Important in TB Control?
Household contacts are a crucial focus in tuberculosis (TB) control efforts because:
- Increased Risk: They share the same living environment as the index TB patient, leading to increased exposure to Mycobacterium tuberculosis, the bacteria that causes TB.
- Early Detection: Screening HHC allows for early detection of TB infection or active TB disease, enabling timely treatment and preventing further spread.
- Preventive Therapy: Providing TB preventive treatment (TPT) to HHC significantly reduces their risk of developing active TB disease.
Key Considerations for HHC Screening and Management:
- Screening: HHC should be screened for TB infection (using tests like the tuberculin skin test or interferon-gamma release assays) and active TB disease (through chest X-rays and sputum testing, if indicated).
- Prioritization: Children under 5 years of age and people living with HIV who are HHC should be prioritized for TPT, regardless of TB infection status (after ruling out active TB disease).
- TPT Regimens: Various TPT regimens are available, including isoniazid, rifapentine, or rifampicin, depending on the individual's risk factors and drug susceptibility patterns of the index case.
- Adherence: Ensuring adherence to TPT is critical for its effectiveness. Patient education, support, and regular monitoring are essential.
- Index Case Management: Proper management of the index TB patient, including effective treatment and infection control measures, is equally crucial to minimize transmission within the household.
By focusing on identifying and managing household contacts, TB control programs can effectively interrupt the chain of TB transmission and reduce the burden of TB disease.
