scholarly journals Latent tuberculosis infection in foreign-born communities: import vs. transmission in the Netherlands derived through mathematical modelling

2017 ◽  
Author(s):  
Hester Korthals Altes ◽  
Serieke Kloet ◽  
Frank Cobelens ◽  
Martin Bootsma
Keyword(s):  
The Netherlands ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Preventive Treatment ◽  
Tuberculosis Infection ◽  
Foreign Born ◽  
Contact Investigation ◽  
Low Incidence ◽  
A Minor ◽  
Significant Disease

AbstractWhile tuberculosis represents a significant disease burden worldwide, low-incidence countries strive to reach the WHO target of elimination by 2025. Screening for TB in immigrants is an important component of the strategy to reduce the TB burden in low-incidence settings. An important option is the screening and preventive treatment of latent tuberculosis infection (LTBI). Whether this policy is worthwhile depends on the extent of transmission within the country, and introduction of new cases through import. Mathematical transmission models of tuberculosis have been used to identify key parameters in the epidemiology of TB and estimate transmission rates. An important application has also been to investigate the consequences of policy scenarios.Here, we formulate a mathematical model for TB transmission within the Netherlands to estimate the size of the pool of latent infections, and to determine the share of importation –either through immigration or travel- versus transmission within the Netherlands. We take into account importation of infections due to immigration, and travel to the country of origin, focusing on the three ethnicities most represented among TB cases, excluding those overrepresented in asylum seekers: Moroccans, Turkish and Indonesians. We fit a system of ordinary differential equations to the data from the Netherlands Tuberculosis Registry on (extra-)pulmonary TB cases from 1995-2013.We find that for all three foreign-born communities, immigration is the most important source of LTBI, but the extent of within-country transmission is much lower (about half) for the Turkish and Indonesian communities than for the Moroccan. This would imply that contact investigation would have a greater yield in the latter community than in the former. Travel remains a minor factor contributing LTBI, suggesting that targeting returning travelers might be less effective at preventing LTBI than immigrants upon entry in the country.

scholarly journals Risk of developing tuberculosis disease among persons diagnosed with latent tuberculosis infection in the Netherlands

2016 ◽  
Vol 48 (5) ◽  
pp. 1420-1428 ◽  
Author(s):  
Connie G.M. Erkens ◽  
Erika Slump ◽  
Maurits Verhagen ◽  
Henrieke Schimmel ◽  
Frank Cobelens ◽  
...  
Keyword(s):  
The Netherlands ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Preventive Treatment ◽  
Risk Groups ◽  
Incidence Rates ◽  
Tuberculosis Infection ◽  
Foreign Born ◽  
Target Groups ◽  
Associated Risk Factors

Diagnosis and preventive treatment of latent tuberculosis infection (LTBI) among high-risk groups is recommended to achieve tuberculosis (TB) elimination in low-incidence countries.We studied TB incidence rates among those notified with LTBI in the Netherlands from 2005 to 2013 and analysed associated risk factors. We stratified analyses by target group for screening, and by initiation and completion of preventive treatment.The incidence for those completing, stopping and not receiving preventive treatment was 187, 436 and 355 per 100 000 person-years for contacts of TB patients, respectively, and 63, 96 and 110 per 100 000 person-years for other target groups. The rate ratio for TB development among contacts compared to other target groups was 3.1 (95% CI 2.0–4.9). In both groups, incidence was highest in the first year after diagnosis. Independent factors associated with progression to TB among contacts were age <5 years and stopping preventive treatment within 28 days compared to those not receiving preventive treatment. Among other target groups, being foreign born was the only risk factor associated with the risk of developing TB.We conclude that the epidemiological impact of preventive treatment is highest in contacts of TB patients and limited in other target groups for LTBI management in the Netherlands.

scholarly journals Implementation of latent tuberculosis infection screening and treatment among newly arriving immigrants in the Netherlands: A mixed methods pilot evaluation

PLoS ONE ◽  
2019 ◽  
Vol 14 (7) ◽  
pp. e0219252 ◽  
Author(s):  
Ineke Spruijt ◽  
Connie Erkens ◽  
Jeanine Suurmond ◽  
Erik Huisman ◽  
Marga Koenders ◽  
...  
Keyword(s):  
Mixed Methods ◽  
The Netherlands ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection

The effectiveness of programmatic management of latent tuberculosis infection in the Netherlands

2015 ◽  
Author(s):  
Connie Erkens ◽  
Erika Slump ◽  
Maurits Verhagen ◽  
Henrieke Schimmel ◽  
Gerard De Vries ◽  
...  
Keyword(s):  
The Netherlands ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection

scholarly journals VITAMIN D AND LATENT TUBERCULOSIS INFECTION IN SCHOOLCHILDREN

2019 ◽  
Vol 22 (6) ◽  
pp. 344-348
Author(s):  
A. D. Petrushina ◽  
Daria M. Slashcheva ◽  
N. S. Brynza ◽  
N. D. Pirogova ◽  
S. V. Sosnovskaya ◽  
...  
Keyword(s):  
Vitamin D ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Preventive Treatment ◽  
Tuberculosis Infection ◽  
World Health ◽  
Skin Tests ◽  
Initial Examination ◽  
Treatment And Prevention ◽  
Vitamin D Levels

The World Health Organization has adopted the global TB strategy for the period of 2016-2035. To achieve its targets, it is necessary to propose and introduce new approaches for the prevention and treatment of latent tuberculosis infection (LTBI) in children and adolescents, as a potential source of active tuberculosis development. In this regard, the use of vitamin D (cholecalciferol) may become promising in combating tuberculosis, since most researchers suppose an adequate level of cholecalciferol to have a positive preventive and therapeutic effect in children with active and latent tuberculosis. So far the use of vitamin D may be appropriate, especially in children not adequately provided with vitamin D. The paper presents the results of the vitamin D levels study before and after prescribing cholecalciferol, as well as the dynamics of the tuberculin skin tests in school-age LTBI children receiving preventive treatment with anti-TB drugs. At the initial examination, a normal level of 25-hydroxycholecalciferol (25(OH)D) was not detected in any child. After 3 months of administration of vitamin D in therapeutic doses, a normal concentration of 25(OH)D was observed in 52% of the children examined repeatedly. Analysis of the tuberculin skin test dynamics showed 47.6% of children to have a negative/doubtful test result after 3 months of treatment with anti-TB drugs and vitamin D. In 9.5% of patients, the size of the papule did not change during treatment. It is important to note that in these children, the 25(OH)D level also did not increase. А vitamin D intake at a therapeutic dosage did not cause hypercalcemia or hypercalciuria in any child. LTBI children are inadequately provided with cholecalciferol. There fore it is necessary to determine the level of vitamin D in the blood, then to prescribe the vitamin D, regardless of the time of year, along with standard therapy for a more effective outcome of LTBI treatment and prevention of active forms of tuberculosis in the future.

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