Zenner, D;
Loutet, MG;
Harris, R;
Wilson, S;
Ormerod, LP;
(2017)
Evaluating 17 years of latent tuberculosis infection screening in north-west England: a retrospective cohort study of reactivation.
European Respiratory Journal
, 50
(1)
, Article 1602505. 10.1183/13993003.02505-2016.
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Abstract
Approximately 72% of tuberculosis (TB) cases in England occur among non-UK born individuals, mostly as a result of reactivation of latent TB infection (LTBI). Programmatic LTBI screening is a key intervention of the TB strategy for England. This article reviews the results of a long-standing LTBI screening initiative in England. A retrospective cohort was created through probabilistic linkage between LTBI screening data and national TB case notifications. Screened persons were followed until they died, became a case, emigrated or until cohort-end. TB incidence rates and rate ratios (IRR) were calculated. 97 out of 1820 individuals screened for LTBI were reported to have active TB. Crude incidence rates among LTBI-positive, treatment-naïve individuals were 4.1 and 2.3 per 100 person-years in the QuantiFERON and tuberculin skin test cohorts, respectively. Among the QuantiFERON cohort, Poisson regression showed that LTBI positivity (IRR 22.6, 95% CI 6.8–74.6) and no chemoprophylaxis increased the probability of becoming a TB case (IRR 0.17, 95% CI 0.05–0.6). We found high TB rates in LTBI-positive, treatment-naïve individuals and a strong association between no treatment and becoming a TB case, demonstrating feasibility and effectiveness of LTBI screening and providing important policy lessons for LTBI screening in England and beyond.
Type: | Article |
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Title: | Evaluating 17 years of latent tuberculosis infection screening in north-west England: a retrospective cohort study of reactivation |
Open access status: | An open access version is available from UCL Discovery |
DOI: | 10.1183/13993003.02505-2016 |
Publisher version: | http://doi.org/10.1183/13993003.02505-2016 |
Language: | English |
Additional information: | Copyright ©ERS 2017. This version is distributed under the terms of the Creative Commons Attribution NonCommercial Licence 4.0. |
Keywords: | Science & Technology, Life Sciences & Biomedicine, Respiratory System, GAMMA RELEASE ASSAYS, METAANALYSIS, UK, ELIMINATION, COUNTRIES, RISK |
UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
URI: | https://discovery.ucl.ac.uk/id/eprint/10024967 |
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