Tuberculosis-related stigma leading to an incomplete contact investigation in a low-incidence country.


A contact investigation following a case of infectious tuberculosis (TB) reported in a call centre in Milan (Italy) led to the identification of three additional cases that had occurred in employees of the same workplace during the previous 5 years, one of whom was the probable source case. Thirty-three latent infections were also identified. At the time of diagnosis, the source case, because of fear of stigma related to TB, claimed to be unemployed and a contact investigation was not performed in the workplace. Cases were linked through genotyping of Mycobacterium tuberculosis. TB stigma has been described frequently, mainly in high-incidence settings, and is known to influence health-seeking behaviours and treatment adherence. The findings in this report highlight that TB-associated stigma may also lead to incomplete contact investigations. Little is known about the causes and impact of TB-related stigma in low-incidence countries and this warrants further exploration. Research is also needed to evaluate the effectiveness of specific interviewing techniques and training interventions for staff in reducing feelings of stigma in TB patients. Finally, the outbreak emphasizes the importance of integrating routine contact investigations with genotyping.

DOI: 10.1017/S095026881400394X

Cite this paper

@article{Faccini2015TuberculosisrelatedSL, title={Tuberculosis-related stigma leading to an incomplete contact investigation in a low-incidence country.}, author={Marino Faccini and Susanna Cantoni and Giorgio Ciconali and Maria Teresa Filipponi and Giulia Mainardi and Anna F. Marino and Sergio Senatore and Luigi Ruffo Codecasa and Maurizio Ferrarese and Giovanni Pietro Gesu and Erica Mazzola and Antonietta Filia}, journal={Epidemiology and infection}, year={2015}, volume={143 13}, pages={2841-8} }