scholarly journals A Targeted Screening Program for Latent Tuberculosis Infection Among Hematopoietic Cell Transplant Recipients

2020 ◽  
Vol 7 (7) ◽  
Author(s):  
Andrea Sosa-Moreno ◽  
Masahiro Narita ◽  
Christopher Spitters ◽  
Michelle Swetky ◽  
Sara Podczervinski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Latent Tuberculosis Infection ◽  
Screening Program ◽  
Latent Tuberculosis ◽  
Hematopoietic Cell ◽  
Tuberculosis Infection ◽  
Tuberculin Skin Testing ◽  
Targeted Screening ◽  
Low Prevalence ◽  
Ltbi Testing

Abstract Background US hematopoietic cell transplantation (HCT) recipients have a low prevalence of latent tuberculosis infection (LTBI), but if latently infected they are at risk for progression to active tuberculosis. At our center, all HCT recipients underwent LTBI testing pretransplant by tuberculin skin testing (TST) until 2013 when we implemented a targeted screening program. Our objective was to assess the utility of our screening program that incorporated a pretransplant LTBI questionnaire to target TST and QuantiFERON TB Gold (QFT) testing. Methods We performed a retrospective cohort study of HCT recipients undergoing first transplant from 2014 to 2016. Patients with positive, indeterminate, and a subset with negative QFT results underwent electronic medical record (EMR) review to assess TST results and risk factors for LTBI. Results Among 1290 eligible recipients, 457 (35%) had at least 1 risk factor for LTBI on the pretransplant questionnaire; nonwhites were more likely to undergo LTBI testing (P < .0001). Overall, 16 of 1290 (1.2%) had at least 1 positive LTBI test. Of those screened by QFT, 14 of 457 (3%) were positive and 52 (11%) were indeterminate. Among those undergoing EMR review, 123 of 267 (46%) had TST records; 4 of 123 (3%) positive by both TST and QFT, and 2 (2%) by TST alone. Two or more risk factors were reported among the majority of LTBI-positive patients (15 of 16 [94%]). All patients with at least 1 positive test for LTBI (n = 16) were evaluated, and 11 of 16 (69%) were recommended to receive treatment. Conclusions Incorporating a pretransplant LTBI questionnaire allowed for an approximate 65% reduction in LTBI testing when compared with universal testing among this low prevalence population.

scholarly journals Diagnosis and Risk Factors of Latent Tuberculosis Infection among Healthcare Workers Using Whole Blood Human Interferon-gamma Release Assay and Tuberculin Skin Testing

2020 ◽  
pp. 15-21
Author(s):  
A. N. Umo ◽  
O. J. Akinjogunla ◽  
N. O. Umoh ◽  
G. E. Uzono
Keyword(s):  
Risk Factors ◽  
Interferon Gamma ◽  
Whole Blood ◽  
Healthcare Workers ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Interferon Gamma Release Assay ◽  
Tuberculin Skin Testing ◽  
Release Assay

This study established the diagnosis and risk factors of latent tuberculosis infection (LTBI) among health-care workers in an endemic population using Tuberculin skin test (TST) and Quantiferon TB-gold. A total of 609 Healthcare workers from tuberculosis treatment facilities in Akwa Ibom State, Nigeria were studied. The Interferon-gamma release assay was performed using 3ml of whole blood by ELISA according to the manufacturer’s instruction (Cellestis Ltd., Carnegie, Australia) after which 0.1 ml of 5 tuberculin units of Purified Protein Derivative (PPD) was administered intra-dermally to each subject. TST results were read after 72 hours by measuring the size of indurations in millimetres. Data were analysed using SPSS version 17 (SPSS Inc., Chicago, Illinois). At the threshold of 10 mm, the prevalence of LTBI by TST was 45.8% and 24.8% at the IGRA diagnostic value of ≥ 0.351 IU. Laboratory staff and ward orderlies as well as being in service for >10 years, were more significantly associated with LTBI. A moderate agreement of 76.7%, k = 0.51 was obtained between TST at 10 mm, and QFT. Neither previous exposure to TST nor BCG vaccination affected the prevalence of LTBI in the study population. The difference of 54% prevalence of LTBI between TST and QFT may be due to non-tuberculous mycobacterium (NTM) since TST is non-specific. This may have grave implications of drug toxicity and development of resistance to anti-TB drug among individuals harbouring NTM, but receiving anti-TB medication. The 76.7% agreement between the two tests is an indication that the 10 mm cut-off induration for TST is still relevant in the diagnosis of LTBI.

scholarly journals Prevalence of latent tuberculosis infection and associated risk factors in prison in East Wollega Zone of western Ethiopia

PLoS ONE ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. e0233314
Author(s):  
Basha Chekesa ◽  
Balako Gumi ◽  
Mahlet Chanyalew ◽  
Aboma Zewude ◽  
Gobena Ameni
Keyword(s):  
Risk Factors ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Associated Risk Factors ◽  
Western Ethiopia

scholarly journals 754. Prevalence of Latent Tuberculosis Infection Among Healthcare Workers at a Tertiary Care University Hospital

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S271-S271
Author(s):  
Eun Ju Choo ◽  
Se Yoon Park
Keyword(s):  
Risk Factors ◽  
Healthcare Workers ◽  
Latent Tuberculosis Infection ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
University Hospital ◽  
Increased Risk ◽  
High Prevalence ◽  
Univariate Analyses

Abstract Background We investigated the prevalence of latent tuberculosis infection (LTBI) among healthcare workers (HCWs) and analyzed its risk factors in a tertiary care university hospital in South Korea in a population with intermediate tuberculosis (TB) burden. Methods A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant. QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay and chest radiography were performed to investigate the rate of LTBI. Results A total of 1,429 participants, 213 (14.9%) doctors and 988 (69.1%) nurses and 228 (16.0%) others were enrolled. The mean age of the subjects was 33.0 years old, and 1,175 (82.2%) were female. Of the participants, 94.5% had received BCG vaccine. QFT-GIT assays were positive for 156 subjects (10.9%). Of the 213 doctors, 28 (13.1%) were positive by QFT-GIT, and among the 988 nurses, 94 (9.5%) had positive QFT-GIT results. Experience of working in hospital was significantly associated with positive LTBI test results by QFT-GIT assay. Gender and duration of employment as an HCW were significantly associated with having a positive QFT-GIT result in univariate analyses. In multivariate analyses, duration of employment as an HCW (>15 years) (odds ratio, 1.98; 95% confidence interval, 1.14–3.43) was independently associated with increased risk of a positive QFT-GIT result. Conclusion A high prevalence of LTBI was found among our HCWs. Considering the association between the experience of working in hospital and high risk of LTBI. The risk for tuberculosis infection among HCWs was higher than general population, which suggests that stricter preventive strategies against nosocomial tuberculosis infection should be implemented. Disclosures All authors: No reported disclosures.

scholarly journals Modeling the Impact of Recommendations for Primary Care–Based Screening for Latent Tuberculosis Infection in California

2020 ◽  
Vol 135 (1_suppl) ◽  
pp. 172S-181S
Author(s):  
Andrea Parriott ◽  
James G. Kahn ◽  
Haleh Ashki ◽  
Adam Readhead ◽  
Pennan M. Barry ◽  
...  
Keyword(s):  
Primary Care ◽  
Latent Tuberculosis Infection ◽  
Task Force ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
California Department ◽  
The Us ◽  
Almost All ◽  
The Impact ◽  
Ltbi Testing

Objective Targeted testing and treatment of persons with latent tuberculosis infection (LTBI) is a critical component of the US tuberculosis (TB) elimination strategy. In January 2016, the California Department of Public Health issued a tool and user guide for TB risk assessment (California tool) and guidance for LTBI testing, and in September 2016, the US Preventive Services Task Force (USPSTF) issued recommendations for LTBI testing in primary care settings. We estimated the epidemiologic effect of adherence to both recommendations in California. Methods We used an individual-based Markov micro-simulation model to estimate the number of cases of TB disease expected through 2026 with baseline LTBI strategies compared with implementation of the USPSTF or California tool guidance. We estimated the risk of LTBI by age and country of origin, the probability of being in a targeted population, and the probability of presenting for primary care based on available data. We assumed 100% adherence to testing guidance but imperfect adherence to treatment. Results Implementation of USPSTF and California tool guidance would result in nearly identical numbers of tests administered and cases of TB disease prevented. Perfect adherence to either recommendation would result in approximately 7000 cases of TB disease averted (40% reduction compared with baseline) by 2026. Almost all of this decline would be driven by a reduction in the number of cases among non–US-born persons. Conclusions By focusing on the non–US-born population, adherence to LTBI testing strategies recommended by the USPSTF and the California tool could substantially reduce the burden of TB disease in California in the next decade.

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