Defining the Optimal Threshold for Latent Tuberculosis Infection Testing for People Living with HIV: Results of a UK Screening Programme

2021 ◽  
Author(s):  
Helena Angharad White ◽  
Rebecca Baggaley ◽  
Hajra Okhai ◽  
Hemu Patel ◽  
Iain Stephenson ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Screening Programme ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Optimal Threshold ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Determinants of losses in the latent tuberculosis infection cascade of care in Brazil

2021 ◽  
Vol 6 (9) ◽  
pp. e005969
Author(s):  
Alexandra Brito Souza ◽  
María B Arriaga ◽  
Gustavo Amorim ◽  
Mariana Araújo-Pereira ◽  
Betânia M F Nogueira ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Clinical Investigation ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Radiographic Examination ◽  
Interferon Gamma Release Assay ◽  
People Living With Hiv ◽  
Cascade Of Care ◽  
Living With Hiv ◽  
Close Contacts

IntroductionFactors associated with losses in the latent tuberculosis infection (LTBI) cascade of care in contacts of patients with tuberculosis (TB) were investigated in a multicentre prospective cohort from highly endemic regions in Brazil.MethodsClose contacts of 1187 patients with culture-confirmed pulmonary TB were prospectively studied between 2015 and 2019, with follow-up of 6–24 months. Data on TB screening by clinical investigation, radiographic examination and interferon-gamma release assay (IGRA) were collected. Multivariable regressions were used to identify determinants of losses in the LTBI cascade.ResultsAmong 4145 TB contacts initially identified, 1901 were examined (54% loss). Among those examined, 933 were people living with HIV, ≤5 years old and/or had positive IGRA results, and therefore had a recommendation to start TB preventive treatment (TPT). Of those, 454 (23%) initiated treatment, and 247 (54% of those initiating; 26% of those in whom treatment was recommended) completed TPT. Multivariable regression analysis revealed that living with HIV, illiteracy and black/pardo (brown) race were independently associated with losses in the cascade.ConclusionThere were losses at all LTBI cascade stages, but particularly at the initial screening and examination steps. Close contacts of low socioeconomic status and living with HIV were at heightened risk of not completing the LTBI cascade of care in Brazil.

scholarly journals Determinants of losses in the latent tuberculosis infection cascade of care in Brazil: a prospective multicenter cohort study

2021 ◽  
Author(s):  
Alexandra Brito Souza ◽  
María B. Arriaga ◽  
Gustavo Amorim ◽  
Mariana Araújo-Pereira ◽  
Betânia M. F. Nogueira ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Radiographic Examination ◽  
Interferon Gamma Release Assay ◽  
People Living With Hiv ◽  
Factors Associated ◽  
Cascade Of Care ◽  
Living With Hiv ◽  
Close Contacts

ABSTRACTBackgroundFactors associated with losses in the latent tuberculosis infection (LTBI) cascade of care in contacts of tuberculosis (TB) patients were investigated in a multicenter prospective cohort from highly endemic regions in Brazil.MethodsClose contacts of 1,187 culture-confirmed pulmonary TB patients were prospectively studied between 2015 and 2019, with follow-up between 6 and 24 months. Data on TB screening by clinical investigation, radiographic examination and interferon-gamma release assay (IGRA) were collected. Stepwise multivariable models were used to identify determinants of losses in the LTBI cascade.ResultsAmong 4,145 TB contacts initially identified, 1,901 were examined (54% loss). Within those individuals, 933 were people living with HIV, ≤5 years-old and/or had positive IGRA results, therefore having recommendation to start TB preventive treatment (TPT). Of those, 454 (23%) initiated treatment, and 247 (6% of all TB contacts) completed TPT. Multivariable regression analysis revealed that living with HIV, illiteracy, and black/pardo (brown) race were independently associated with losses in cascade.ConclusionThere were losses at all LTBI cascade stages, but particularly at the initial screening and examination steps. Close contacts who are socially vulnerable and living with HIV were at heightened risk of not completing the LTBI cascade of care in Brazil.40-word summary of the article’s main pointWe investigated factors associated with losses in the latent tuberculosis infection cascade of care in a large cohort of contacts in Brazil. Social vulnerability and HIV infection were the most relevant determinants of losses in the LTBI cascade of care.

scholarly journals Continuous isoniazid for the treatment of latent tuberculosis infection in people living with HIV

AIDS ◽  
2016 ◽  
Vol 30 (5) ◽  
pp. 797-801 ◽  
Author(s):  
Saskia Den Boon ◽  
Alberto Matteelli ◽  
Nathan Ford ◽  
Haileyesus Getahun
Keyword(s):  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Systematic review of latent tuberculosis infection research to inform programmatic management in Ireland

2021 ◽  
Author(s):  
James O’Connell ◽  
Eoghan de Barra ◽  
Samuel McConkey
Keyword(s):  
Systematic Review ◽  
Latent Tuberculosis Infection ◽  
Meta Analysis ◽  
Latent Tuberculosis ◽  
Risk Groups ◽  
Tuberculosis Infection ◽  
World Health ◽  
People Living With Hiv ◽  
Knowledge Gaps ◽  
Ltbi Screening

AbstractThe World Health Organisation (WHO) End Tuberculosis (TB) Strategy and the WHO Framework Towards Tuberculosis Elimination in Low Incidence Countries state that latent tuberculosis infection (LTBI) screening and treatment in selected high-risk groups is a priority action to eliminate TB. The European Centre for Disease Prevention and Control (ECDC) advises that this should be done through high-quality programmatic management, which they describe as having six key components. The research aim was to systematically review the literature to identify what is known about the epidemiology of LTBI and the uptake and completion of LTBI screening and treatment in Ireland to inform the programmatic management of LTBI nationally. A systematic literature review was performed according to a review protocol and reported in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Twenty-eight studies were eligible for inclusion and described LTBI screening or treatment performed in one of five contexts, pre-biologic or other immunosuppression screening, people living with HIV, TB case contacts, other vulnerable populations, or healthcare workers. The risk of bias across studies with regard to prevalence of LTBI was generally high. One study reported a complete cascade of LTBI care from screening initiation to treatment completion. This systematic review has described what published research there is on the epidemiology and cascade of LTBI care in Ireland and identified knowledge gaps. A strategy for addressing these knowledge gaps has been proposed.

Tuberculosis in healthcare workers, Scotland

2017 ◽  
Vol 62 (3) ◽  
pp. 101-103 ◽  
Author(s):  
Kevin G Pollock ◽  
Eisin McDonald ◽  
Alison Smith-Palmer ◽  
Fiona Johnston ◽  
Syed Ahmed
Keyword(s):  
Incidence Rate ◽  
Healthcare Workers ◽  
Latent Tuberculosis Infection ◽  
Screening Programme ◽  
Latent Tuberculosis ◽  
Mycobacterial Infection ◽  
Population Based ◽  
Tuberculosis Infection ◽  
The Mean ◽  
The Uk

In an attempt to explore healthcare worker acquisition of tuberculosis infection, we conducted population-based surveillance of all cases recorded as healthcare workers reported to Enhanced Surveillance of Mycobacterial Infection from 2000 to 2015. Over the study period, the mean incidence rate of tuberculosis among all healthcare workers was 15.4 per 100,000 healthcare workers. However, the incidence rate of tuberculosis amongst those healthcare workers born outside the UK was 164.8 per 100,000 compared with 5.0 per 100,000 UK-born healthcare workers. Fifty-seven per cent of all non-UK-born healthcare workers were diagnosed within five years of their arrival in the UK and would have been new entrants to the NHS. An effective new entrant occupational health screening programme for latent tuberculosis infection may have prevented some of these active cases of infection.

scholarly journals Latent Tuberculosis Infection - Diagnosis and Treatment

2018 ◽  
Vol 6 (4) ◽  
pp. 651-655 ◽  
Author(s):  
Biljana Ilievska-Poposka ◽  
Marija Metodieva ◽  
Maja Zakoska ◽  
Cveta Vragoterova ◽  
Dejan Trajkov
Keyword(s):  
Latent Tuberculosis Infection ◽  
Age Groups ◽  
Latent Tuberculosis ◽  
Risk Groups ◽  
Tuberculosis Infection ◽  
Diagnosis And Treatment ◽  
People Living With Hiv ◽  
Treatment Regimes ◽  
Rifampicin Treatment ◽  
Igra Test

INTRODUCTION: Latent tuberculosis infection (LTBI) is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens without evidence of clinically manifested active tuberculosis (TB). Diagnosis and treatment for LTBI are important for TB, especially in high-risk populations. Tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) are used to diagnose LTBI.AIM: The study aims to present the first results with IGRA test compared with TST in the screening of LTBI and the treatment results in the cases with LTBI in Macedonia.MATERIAL AND METHODS: In this study 73 cases diagnosed and treated with LTBI in 2016 were included. For diagnosis of LTBI, we used TST RT -23 5T.U. and commercial IGRA test such as QuantiFERON-TB Gold In-Tube (QFT-IT).RESULTS: Out of 73 cases with LTBI, 61.64% were men, and 38.36% were women. Among all age groups, the most frequent were cases between 5 and 14 years old (54.79%). Among the evaluated risk groups for LTBI, the most frequent were children household contacts with pulmonary TB cases (61-83.65%), followed by people living with HIV (9-12.33%) and only 3 cases with other medical reasons. Positive TST had 34 cases (46.57%) and positive IGRA test 25 cases (34.25%). Regarding the treatment regimes, we use two regimes: 50 cases (68.44%) received 6 months daily regime with Isoniazid, and 23 cases (31.51%) received 3 months daily regime with Isoniazid and Rifampicin. Treatment outcomes showed that the most patients completed treatment regimes: 55 (75.34%) and only 10 (13.09%) interrupted the treatment.CONCLUSION: Despite the progress made in the last few years, several challenges remain to be addressed for better management of LTBI which will contribute to strength TB control in the country.

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