{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:42:18Z","timestamp":1787244138352,"version":"build-2736575974"},"reference-count":34,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"STOP TB Partnership","award":["W7_IDN_CDT1_Burnet"],"award-info":[{"award-number":["W7_IDN_CDT1_Burnet"]}]},{"name":"Australian Government\u2019s Indo-Pacific Centre","award":["W7_IDN_CDT1_Burnet"],"award-info":[{"award-number":["W7_IDN_CDT1_Burnet"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>In Indonesia, the implementation of tuberculosis (TB) contact investigation is limited, with low detection rates. We report the yield of and risk factors for TB disease and infection for household contacts (HHCs) investigated using chest X-ray (CXR) screening. We identified HHCs aged five years and above of bacteriologically confirmed index cases from 2018 to 2022 in Yogyakarta City and Kulon Progo. All HHCs were offered screening for TB symptoms; TB infection testing with either tuberculin skin testing or interferon gamma release assay; and referral for CXR. Sputum from those with symptoms or CXR suggestive of TB was tested with Xpert MTB\/RIF. Risk factors for active TB disease and latent TB infection (LTBI) were identified by logistic regression models. We screened 2857 HHCs for TB between June 2020 and December 2022, with 68 (2.4%) diagnosed with active TB. Of 2621 HHCs eligible for LTBI investigation, 1083 (45.7%) were diagnosed with LTBI. The factors associated with active TB were age, being underweight, diabetes mellitus, urban living, and sleeping in the same house as an index case. Factors associated with LTBI were increasing age and male gender. Conclusions: Screening for HHC including CXR and TST\/IGRA yielded a moderate prevalence of TB disease and infection.<\/jats:p>","DOI":"10.3390\/tropicalmed9020034","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T09:41:59Z","timestamp":1706694119000},"page":"34","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Yield of Active Tuberculosis Disease and Latent Tuberculosis Infection in Tuberculosis Household Contacts Investigated Using Chest X-ray in Yogyakarta Province, Indonesia"],"prefix":"10.3390","volume":"9","author":[{"given":"Betty","family":"Nababan","sequence":"first","affiliation":[{"name":"Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Sleman, Yogyakarta 55281, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Triasih","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Sleman, Yogyakarta 55281, Indonesia"},{"name":"Department of Pediatric, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Dr. Sardjito Hospital, Sleman, Yogyakarta 55281, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6731-2864","authenticated-orcid":false,"given":"Geoffrey","family":"Chan","sequence":"additional","affiliation":[{"name":"TB Elimination and Implementation Science Working Group, Burnet Institute, Melbourne, VIC 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bintari","family":"Dwihardiani","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Sleman, Yogyakarta 55281, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif","family":"Hidayat","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Sleman, Yogyakarta 55281, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Setyogati C.","family":"Dewi","sequence":"additional","affiliation":[{"name":"Yogyakarta City Health Office, Yogyakarta, Yogyakarta 55165, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lana","family":"Unwanah","sequence":"additional","affiliation":[{"name":"Yogyakarta City Health Office, Yogyakarta, Yogyakarta 55165, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif","family":"Mustofa","sequence":"additional","affiliation":[{"name":"Kulon Progo District Health Office, Yogyakarta, Yogyakarta 55165, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"du Cros","sequence":"additional","affiliation":[{"name":"TB Elimination and Implementation Science Working Group, Burnet Institute, Melbourne, VIC 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,31]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022). Global Tuberculosis Report 2022, World Health Organization."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1093\/aje\/kwaa028","article-title":"Modeling Missing Cases and Transmission Links in Networks of Extensively Drug-Resistant Tuberculosis in KwaZulu-Natal, South Africa","volume":"189","author":"Nelson","year":"2020","journal-title":"Am. J. Epidemiol."},{"key":"ref_3","unstructured":"(2019). Direktorat Jenderal Pencegahan dan Pengendalian Penyakit Kementerian Kesehatan Republik Indonesia Petunjuk Teknis Investigasi Kontak Pasien TBC Bagi Petugas Kesehatan Dan Kader, Kementerian Kesehatan Republic Indonesia."},{"key":"ref_4","unstructured":"Ministry of Health of the Republic of Indonesia (2023, September 27). TB Indonesia. \u00a9 2023 TBC Indonesia. Available online: https:\/\/Tbindonesia.or.Id\/."},{"key":"ref_5","unstructured":"WHO Consolidated Guidelines on Tuberculosis (2021). Module 2: Systematic Screening for Tuberculosis Disease, World Health Organization."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e259","DOI":"10.1016\/S2468-2667(22)00001-9","article-title":"Effectiveness of Contact Tracing in the Control of Infectious Diseases: A Systematic Review","volume":"7","author":"Hossain","year":"2022","journal-title":"Lancet Public Health"},{"key":"ref_7","unstructured":"Badan Pusat Statistik Provinsi D.I Yogyakarta (2022). Analisis Profil Penduduk Analisis Tematik Kependudukan: Peran Lintas Generasi Dalam Pembangunan D.I.Yogyakarta, Badan Pusat Statistik Provinsi D.I Yogyakarta."},{"key":"ref_8","unstructured":"World Health Organization (2020). WHO Operational Handbook on Tuberculosis, Module 1: Prevention: Tuberculosis Preventive Treatment, World Health Organization."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e13520","DOI":"10.1111\/obr.13520","article-title":"Obesity in South and Southeast Asia\u2014A New Consensus on Care and Management","volume":"24","author":"Tham","year":"2023","journal-title":"Obes. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research Electronic Data Capture (REDCap)-A Metadata-Driven Methodology and Workflow Process for Providing Translational Research Informatics Support","volume":"42","author":"Harris","year":"2009","journal-title":"J. Biomed Inform."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1183\/09031936.00070812","article-title":"Contact Investigation for Tuberculosis: A Systematic Review and Meta-Analysis","volume":"41","author":"Fox","year":"2013","journal-title":"Eur. Respir. J."},{"key":"ref_12","first-page":"303","article-title":"Prevalence of tuberculosis in household contacts of sputum smears positive cases and associated demographic risk factors","volume":"14","author":"Gyawali","year":"2012","journal-title":"Nepal. Med. Coll. J."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Mac, T.H., Phan, T.H., Van Nguyen, V., Dong, T.T.T., Van Le, H., Nguyen, Q.D., Nguyen, T.D., Codlin, A.J., Mai, T.D.T., and Forse, R.J. (2020). Optimizing Active Tuberculosis Case Finding: Evaluating the Impact of Community Referral for Chest X-ray Screening and Xpert Testing on Case Notifications in Two Cities in Viet Nam. Trop. Med. Infect. Dis., 5.","DOI":"10.3390\/tropicalmed5040181"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"159","DOI":"10.4103\/0970-2113.177445","article-title":"Household Symptomatic Contact Screening of Newly Diagnosed Sputum Smears Positive Tuberculosis Patients\u2014An Effective Case Detection Tool","volume":"33","author":"Gupta","year":"2016","journal-title":"Lung India"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100958","DOI":"10.1016\/j.nmni.2022.100958","article-title":"Household Contact Investigation for the Detection of Active Tuberculosis and Latent Tuberculosis: A Comprehensive Evaluation in Two High-Burden Provinces in Iran","volume":"45","author":"Ghanaiee","year":"2022","journal-title":"New Microbes New Infect."},{"key":"ref_16","first-page":"96","article-title":"Screening for Tuberculosis among Household Contacts of Index Patients","volume":"52","author":"Iqbal","year":"2013","journal-title":"Pak. J. Med. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0162090","article-title":"Household Contact Screening and Yield of Tuberculosis Cases-a Clinic Based Study in Chennai, South India","volume":"11","author":"Nair","year":"2016","journal-title":"PLoS ONE"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Beyanga, M., Kidenya, B.R., Gerwing-Adima, L., Ochodo, E., Mshana, S.E., and Kasang, C. (2018). Investigation of Household Contacts of Pulmonary Tuberculosis Patients Increases Case Detection in Mwanza City, Tanzania. BMC Infect Dis, 18.","DOI":"10.1186\/s12879-018-3036-6"},{"key":"ref_19","unstructured":"Tuberculosis Coalition for Technical Assistance (2014). International Standards for Tuberculosis Care, Tuberculosis Coalition for Technical Assistance. [3rd ed.]."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2991\/jegh.k.190812.002","article-title":"Impact of Advocacy, Communication, Social Mobilization and Active Case Finding on TB Notification in Jharkhand, India","volume":"9","author":"Shewade","year":"2019","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_21","first-page":"1858","article-title":"Interventions to Increase Tuberculosis Case Detection at Primary Healthcare or Community-Level Services","volume":"2017","author":"Mhimbira","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Vo, L.N.Q., Forse, R.J., Codlin, A.J., Vu, T.N., Le, G.T., Do, G.C., Van Truong, V., Dang, H.M., Nguyen, L.H., and Nguyen, H.B. (2020). A Comparative Impact Evaluation of Two Human Resource Models for Community-Based Active Tuberculosis Case Finding in Ho Chi Minh City, Viet Nam. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-09042-4"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Velleca, M., Malekinejad, M., Miller, C., Abascal Miguel, L., Reeves, H., Hopewell, P., and Fair, E. (2021). The Yield of Tuberculosis Contact Investigation in Low- and Middle-Income Settings: A Systematic Review and Meta-Analysis. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06609-3"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1111\/tmi.13693","article-title":"Prevalence and Risk Factors Associated with Latent Tuberculosis Infection among Household Contacts of Smear Positive Pulmonary Tuberculosis Patients in South India","volume":"26","author":"Krishnamoorthy","year":"2021","journal-title":"Trop. Med. Int. Health"},{"key":"ref_25","first-page":"375","article-title":"Risk Factors for Tuberculosis Infection among Household Contacts in Bangkok, Thailand","volume":"35","author":"Tornee","year":"2004","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2157","DOI":"10.4081\/jphia.2022.2157","article-title":"Latent Tuberculosis Infection in Family Members in Household Contact with Active Tuberculosis Patients in Semarang City, Central Java, Indonesia","volume":"13","author":"Karbito","year":"2022","journal-title":"J. Public Health Afr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e830","DOI":"10.1093\/cid\/ciaa1402","article-title":"Subclinical Tuberculosis Disease\u2014A Review and Analysis of Prevalence Surveys to Inform Definitions, Burden, Associations, and Screening Methodology","volume":"73","author":"Frascella","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s40249-019-0515-y","article-title":"Prevalence and Risk Factors of Active Pulmonary Tuberculosis among Elderly People in China: A Population Based Cross-Sectional Study","volume":"8","author":"Zhang","year":"2019","journal-title":"Infect. Dis. Poverty"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11604\/pamj.2020.37.87.21102","article-title":"Latent Tuberculosis among Household Contacts of Pulmonary Tuberculosis Cases in Nairobi, Kenya","volume":"37","author":"Odera","year":"2020","journal-title":"Pan Afr. Med. J."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Lee, S.J., Lee, S.H., Kim, Y.E., Cho, Y.J., Jeong, Y.Y., Kim, H.C., Lee, J.D., Kim, J.R., Hwang, Y.S., and Kim, H.J. (2014). Risk Factors for Latent Tuberculosis Infection in Close Contacts of Active Tuberculosis Patients in South Korea: A Prospective Cohort Study. BMC Infect. Dis., 14.","DOI":"10.1186\/s12879-014-0566-4"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/S1473-3099(11)70069-X","article-title":"Screening of Immigrants in the UK for Imported Latent Tuberculosis: A Multicentre Cohort Study and Cost-Effectiveness Analysis","volume":"11","author":"Pareek","year":"2011","journal-title":"Lancet Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Aabye, M.G., Ravn, P., PrayGod, G., Jeremiah, K., Mugomela, A., Jepsen, M., Faurholt, D., Range, N., Friis, H., and Changalucha, J. (2009). The Impact of HIV Infection and CD4 Cell Count on the Performance of an Interferon Gamma Release Assay in Patients with Pulmonary Tuberculosis. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0004220"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1183\/13993003.01245-2015","article-title":"Management of Latent Mycobacterium tuberculosis Infection: WHO Guidelines for Low Tuberculosis Burden Countries","volume":"46","author":"Getahun","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_34","unstructured":"Kementerian Kesehatan Republik Indonesia (2020). Petunjuk Teknis Penanganan Infeksi Laten Tuberkulosis (ILTB), Kementerian Kesehatan Republik Indonesia."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/9\/2\/34\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:52:03Z","timestamp":1760104323000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/9\/2\/34"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,31]]},"references-count":34,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["tropicalmed9020034"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed9020034","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,31]]}}}