Prevalence and factors associated with latent tuberculosis infection among residents of a monastery situated in a high-TB burden area: A cross sectional study, Sikkim, India

Background: Diagnosis and treatment of Latent Tuberculosis Infection (LTBI) remains to be one of the main bottlenecks in eradication of tuberculosis (TB). TB and LTBI risk among the residents of a congregate facility in a monastery, situated in a high-TB burden area, Sikkim, India, may be high due to their frequent travel history and has never been illustrated. Method: A population based cross sectional screening of all the monks and residents of Rumtek Monastery (Sikkim, India) was carried out for diagnosis of active TB and LTBI. TrueNat MTB and GenXpert MTB/Rif systems were utilized for active TB diagnosis, whereas QFT-plus IGRA analysis was carried out for LTBI detection. LTBI positive cases were followed up with TrueNat MTB system to diagnose any progression to active TB. Results: : Among the 350 residents of the monastery, no participant was found to be having active TB infection; however, ~45% of residents were LTBI positive showing high exposure of disease to the monks belonging to various age groups (9-73 yrs). Participants with frequent travel history, family history of TB or having contacts with TB patients, showed higher percentage of LTBI. Similarly, abnormal BMI showed significant positive correlation with LTBI. Conclusion: This study provides status of high prevalence of LTBI among the residence of a congregate facility in a monastery. These results can be useful to design strategies to treat LTBI in the high TB burden area to achieve the goal of TB elimination.