A 14-year-old girl died of tuberculosis – what should we do to educate contacts of contagious tuberculosis cases?

Pei-Chun Chan

2008 Vol.24 NO.3

Correspondence Author： Pei-Chun Chan

Abstract：

A 14-year-old girl was reported as a pulmonary tuberculosis (TB) case with bilateral cavitary lesions in early September 2007. She was dead on arrival at the hospital and was found to have 3+ bacteria on acid-fast stain. Although having regained vital signs after aggressive resuscitation, she died of multi-organ failure less than 4 days later. Her father was diagnosed with TB 6 years earlier, but had poor compliance with treatment. At that time, this girl received a tuberculin skin test (TST) during contact tracing. Because she had positive TST, a chest X-ray was also performed. Her chest X-ray was normal, and there was no further follow-up. This case came from lower socioeconomic status family. Therefore, despite having weight loss, weakness, and persistent cough, she was rarely seen by physicians. During her clinical visits, she did not mention that she had contact with tuberculosis patients, and the physicians also lacked awareness in suspecting TB.
Low socioeconomic status of the subject, insufficient public health education from the local public health authority, and poor awareness of the physicians examining her led to delayed diagnosis and eventual death of this girl. To resolve these longstanding problems, local health authorities need to have the ability to provide contacts of tuberculosis patients with information on risk of disease development. All caregivers of TB patients, including clinical and public health practitioners, need to understand the importance of contact tracing, in order to decrease the morbidity and mortality of TB.
Keywords: Mortality, public health education, contact, infectious tuberculosis patients