Tuberculosis in Brunei Darussalam

A retrospective cohort study examined the contact investigation process for latent tuberculosis infection (LTBI) in Brunei, analyzing data from 10,537 contacts of 1,048 pulmonary TB (PTB) index cases between 2009 and 2018. Data were obtained from the National Tuberculosis Coordinating Centre (NTCC), which oversees TB prevention and control. The study aimed to assess LTBI diagnosis, treatment initiation and completion, and the progression to active TB disease, considering factors such as demographics, exposure type, and index case characteristics.[1]

Key findings revealed that 9.9% of contacts were diagnosed with LTBI, with higher odds among male contacts, household contacts, and those exposed to smear-positive PTB cases. However, only 43.0% of LTBI cases initiated treatment, with foreign nationals and young children being less likely to start therapy. Of those who initiated treatment, 74.0% completed it, with higher completion rates observed among local residents and those exposed to smear-positive index cases. The study also found that only 0.5% of LTBI cases progressed to active TB, mostly within eight years post-diagnosis, despite most having completed treatment.[1]

These findings highlight disparities in LTBI diagnosis and treatment uptake, particularly among foreign nationals, and underscore the need for targeted interventions to improve treatment initiation. Strategies such as increased awareness, enhanced follow-up, and addressing barriers to treatment can help strengthen TB control efforts. Additionally, further research on reasons for treatment non-initiation and long-term monitoring of LTBI cases is crucial for reducing TB transmission in Brunei.[1]

The annual incidence rate of LTBI in health-care workers in the government sector in Brunei Darussalam ranged from 8.1 to 24.6, with an average of 14.6 over the 4-year period. When comparing treatment acceptance among subgroups, only gender showed statistical significance, with females demonstrating significantly higher treatment acceptance.[2]

References:

1. Chaw, L., Hamid, R.A., Koh, K.S. and Thu, K., 2022. Contact investigation of tuberculosis in Brunei Darussalam: Evaluation and risk factor analysis. BMJ open respiratory research, 9(1).

2. Syafiq, N.J.M., Trivedi, A.A., Lai, A., Fontelera, M.P.A. and Lim, M.A., 2023. Latent tuberculosis infection in health-care workers in the government sector in Brunei Darussalam: A cross-sectional study. Journal of Integrative Nursing, 5(3), pp.197-202.