M Tebruegge1, D Buonsenso2, F Brinkmann3, A Noguera-Julian4, I Pavić5, A Sorete Arbore6, Z Vančíková7, S Velizarova8, S B Welch9, N Ritz10. 1. Academic Unit of Clinical & Experimental Sciences, Faculty of Medicine and Institute for Life Sciences and Global Health Research Institute, University of Southampton, Southampton, UK; Department of Paediatric Infectious Diseases & Immunology and Southampton National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia. 2. Department of Paediatrics, Catholic University of Rome, A Gemelli Hospital, Rome, Italy. 3. Department of Paediatric Pneumology, Ruhr-University, Bochum, Germany. 4. Infectious Diseases Unit, Department of Paediatrics, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain. 5. Department of Paediatric Allergology, Pulmonology, Rheumatology and Clinical Immunology, Children's Hospital Zagreb, Zagreb, Croatia. 6. Clinic of Pulmonary Diseases, Iasi, Romania. 7. Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic. 8. Department of Pulmonary Diseases, Clinic of Pulmonary Diseases in Children, Medical University Sofia, Sofia, Bulgaria. 9. Birmingham Chest Clinic, Heart of England NHS Foundation Trust, Birmingham, UK. 10. Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; University of Basel Children's Hospital, Paediatric Infectious Diseases and Vaccinology, Basel, Switzerland.
Abstract
SETTING: In June 2014, we became aware that shortages of purified protein derivative (PPD), the test substance used for the tuberculin skin test (TST), had occurred in several European health care institutions providing care for children with tuberculosis (TB). OBJECTIVE: To establish the extent of the shortage, a survey was performed. DESIGN: Survey conducted over a 1-month period (June-July 2014) among members of the Paediatric Tuberculosis Network European Trials Group (ptbnet). RESULTS: Thirty-five physicians from 23 European countries contributed data. The most commonly used PPD product was RT23 (Statens Serum Institut; n = 22, 63%). Twenty-one (60%) participants reported that their institution was experiencing a PPD shortage. The majority (n = 17, 81%) of those reporting a shortage were using RT23. Thirteen (37%) participants reported changes in screening practices resulting from the shortage, including sourcing PPD from alternative manufacturers, restricting remaining supplies to patients at greatest risk or replacing TST by an interferon-gamma release assay. CONCLUSIONS: The data show that a PPD shortage occurred in 2014, affecting multiple European countries. The shortage resulted in changes in TB screening capabilities and practices, potentially compromising both patient care as well as public health efforts. Appropriate actions to prevent future PPD shortages should be explored urgently by public health agencies and key stakeholders.
SETTING: In June 2014, we became aware that shortages of purified protein derivative (PPD), the test substance used for the tuberculin skin test (TST), had occurred in several European health care institutions providing care for children with tuberculosis (TB). OBJECTIVE: To establish the extent of the shortage, a survey was performed. DESIGN: Survey conducted over a 1-month period (June-July 2014) among members of the Paediatric Tuberculosis Network European Trials Group (ptbnet). RESULTS: Thirty-five physicians from 23 European countries contributed data. The most commonly used PPD product was RT23 (Statens Serum Institut; n = 22, 63%). Twenty-one (60%) participants reported that their institution was experiencing a PPD shortage. The majority (n = 17, 81%) of those reporting a shortage were using RT23. Thirteen (37%) participants reported changes in screening practices resulting from the shortage, including sourcing PPD from alternative manufacturers, restricting remaining supplies to patients at greatest risk or replacing TST by an interferon-gamma release assay. CONCLUSIONS: The data show that a PPD shortage occurred in 2014, affecting multiple European countries. The shortage resulted in changes in TB screening capabilities and practices, potentially compromising both patient care as well as public health efforts. Appropriate actions to prevent future PPD shortages should be explored urgently by public health agencies and key stakeholders.
Authors: Gerard de Vries; Rob van Hest; Marleen Bakker; Connie Erkens; Susan van den Hof; Wieneke Meijer; Karen Oud; Erika Slump; Jaap van Dissel Journal: J Clin Tuberc Other Mycobact Dis Date: 2017-03-18