M Usdin1, M Dedicoat2, R Gajraj3, P Harrison4, H Kaur5, K Duffield3, C-L Walker3, Y Akram3, V Aiyedun3, H Mohamed3, D Zenner6. 1. Public Health England (PHE) Centre for Infectious Disease Surveillance and Control, London. 2. Heart of England Foundation Trust, Birmingham, UK. 3. PHE West Midlands, Birmingham, UK. 4. South and City College Birmingham, Birmingham, UK. 5. Birmingham & Solihull TB Service, Heart of England National Health Service Trust, Birmingham, UK. 6. Public Health England (PHE) Centre for Infectious Disease Surveillance and Control, London, UK; Centre for Infectious Disease Surveillance and Control, PHE, London, UK; Centre for Infectious Disease Epidemiology, University College London, UK; London, National Institute for Health Research Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Abstract
SETTING: England's national tuberculosis (TB) strategy recommends testing for and treatment of latent tuberculous infection (LTBI) among new migrants. Programmatic testing occurs in primary care, which may be inaccessible for some individuals. Current strategies could therefore be complemented by screening in other settings. OBJECTIVE: To investigate the feasibility and effectiveness of LTBI screening in a community college. DESIGN: A cohort study using observational data collected during the pilot study. Eligible students from high-incidence countries provided consent and were tested with a single-step interferon-gamma release assay (IGRA) and enrolled. We used single and multivariable analyses to estimate screening effectiveness and to explore different subgroups. We included costs from a UK National Health Service perspective. RESULTS: Screening uptake was 75% and treatment completion was 85%. Of 440 students, 71 (16%) were LTBI-positive; two had active TB. There was an association of positivity with age and incidence in the country of origin. Three incidence thresholds met our criteria for screening: countries with >40, >100 and >200 cases per 100 000 population, plus students from sub-Saharan Africa. CONCLUSION: We found that LTBI screening can be offered effectively in a community college, and could be a complement to primary care-based programmes in low-incidence countries.
SETTING: England's national tuberculosis (TB) strategy recommends testing for and treatment of latent tuberculous infection (LTBI) among new migrants. Programmatic testing occurs in primary care, which may be inaccessible for some individuals. Current strategies could therefore be complemented by screening in other settings. OBJECTIVE: To investigate the feasibility and effectiveness of LTBI screening in a community college. DESIGN: A cohort study using observational data collected during the pilot study. Eligible students from high-incidence countries provided consent and were tested with a single-step interferon-gamma release assay (IGRA) and enrolled. We used single and multivariable analyses to estimate screening effectiveness and to explore different subgroups. We included costs from a UK National Health Service perspective. RESULTS: Screening uptake was 75% and treatment completion was 85%. Of 440 students, 71 (16%) were LTBI-positive; two had active TB. There was an association of positivity with age and incidence in the country of origin. Three incidence thresholds met our criteria for screening: countries with >40, >100 and >200 cases per 100 000 population, plus students from sub-Saharan Africa. CONCLUSION: We found that LTBI screening can be offered effectively in a community college, and could be a complement to primary care-based programmes in low-incidence countries.
Authors: Sally Hargreaves; Laura B Nellums; Catherine Johnson; Jacob Goldberg; Panagiotis Pantelidis; Asif Rahman; Jon S Friedland FMedSci Journal: Travel Med Infect Dis Date: 2020-02-29 Impact factor: 6.211
Authors: Ineke Spruijt; Dawit Tesfay Haile; Connie Erkens; Susan van den Hof; Simone Goosen; Andrea Ten Kate; Hewan Teshome; Marja Karels; Marga Koenders; Jeanine Suurmond Journal: BMC Public Health Date: 2020-03-12 Impact factor: 3.295