Identification of a Tuberculosis Cluster through Epidemiological and Geographical Tracing of a Patient with Multidrug-resistant Tuberculosis in Lopburi Province, Thailand, 2014

Abstract

In May 2014, a suspected multidrug-resistant tuberculosis (MDR-TB) outbreak in Lopburi Province was investigated following the national guidelines for tuberculosis (TB) outbreak investigation and assessed the quality of patient care based on the International Standards for TB Care. The case finding focused on TB cases diagnosed during December 2012 to August 2014. Medical charts were reviewed at Khok Samrong Hospital and contacts of a MDR-TB case who was lost to follow up were traced back. Study findings found an epidemiologically linked cluster of TB cases with five geographically related cases and four cases were from the same family. Factors that might have contributed to this TB outbreak were identified as well, including delay in diagnosis and sub-standard care, low socioeconomic status, delay in conducting contact tracing, and an ineffective TB database system. Diagnosis, treatment and prevention activities should be improved to prevent further TB outbreaks in the communities.

Keywords: tuberculosis, multidrug-resistant, contact tracing, quality of care, Thailand