scholarly journals Decision Science at Work: The Case of Latent Tuberculosis Screening

2019 ◽  
Vol 73 (1) ◽  
pp. 8-10
Author(s):  
Abriana Tasillo ◽  
Benjamin P. Linas
Keyword(s):  
Latent Tuberculosis ◽  
Decision Science ◽  
Tuberculosis Screening

scholarly journals S39 Preliminary Results of a Latent Tuberculosis Screening and Treatment Project and the Role of TB Services in Secondary Care

Thorax ◽  
2015 ◽  
Vol 70 (Suppl 3) ◽  
pp. A26.2-A26
Author(s):  
MGK Burman ◽  
G Ahmed ◽  
JL Potter ◽  
VLC White ◽  
N Jayasekera ◽  
...  
Keyword(s):  
Secondary Care ◽  
Latent Tuberculosis ◽  
Tuberculosis Screening ◽  
Preliminary Results

Implementation of latent tuberculosis screening in HIV care centres: evaluation in a low tuberculosis incidence setting

2015 ◽  
Vol 144 (4) ◽  
pp. 703-711 ◽  
Author(s):  
C. WYNDHAM-THOMAS ◽  
K. SCHEPERS ◽  
V. DIRIX ◽  
F. MASCART ◽  
J.-P. VAN VOOREN ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Screening Tools ◽  
Hiv Care ◽  
Screening Methods ◽  
Tuberculosis Screening ◽  
Ltbi Treatment ◽  
Ltbi Screening ◽  
Multiple Choice Questionnaire ◽  
Targeted Approach

SUMMARYThe screening and treatment of latent tuberculosis infection (LTBI) to prevent active tuberculosis (TB) is recommended by the WHO in all HIV-infected patients. The aim of this study was to evaluate its implementation within Belgium's HIV care. A multiple-choice questionnaire was sent to 55 physicians working in the country's AIDS reference centres. Response rate reached 62%. Only 20% screened all their HIV-infected patients for LTBI. Screening methods used and their interpretation vary from one physician to another. The main barriers to the implementation of LTBI screening and treatment, as perceived by the participants, are lack of sensitivity of screening tools, risks associated with polypharmacy and toxicity of treatment. The poor coverage of LTBI screening reported here and the inconsistency in methods used raises concern. However, this was not unexpected as, in low-TB incidence countries, who, when and how to screen for LTBI remains unclear and published guidelines show important disparities. Recently, a targeted approach in which only HIV-infected patients at highest risk of TB are screened has been suggested. Such a strategy would limit unnecessary exposure to LTBI treatment. This methodology was approved by 80% of the participants and could therefore achieve greater coverage. Its clinical validation is still pending.

scholarly journals Tuberculosis Screening and Active Tuberculosis among HIV-Infected Persons in a Canadian Tertiary Care Centre

2009 ◽  
Vol 20 (2) ◽  
pp. 51-57 ◽  
Author(s):  
Paul Brassard ◽  
Travis Salway Hottes ◽  
Richard G Lalonde ◽  
Marina B Klein
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Clinic Visit ◽  
Skin Tests ◽  
Country Of Birth ◽  
Hiv Diagnosis ◽  
Tertiary Care Centre ◽  
Tuberculosis Screening

RATIONALE: HIV infection increases the risk of reactivation of latent tuberculosis (TB). The present study evaluates how latent TB is detected and treated to determine the effectiveness of screening in HIV-infected patients with diverse risk profiles.METHOD: A retrospective medical record database review (1988 to 2007) was conducted at a tertiary care HIV clinic. The proportion of patients receiving tuberculin skin tests (TSTs) and the rate of active TB at each stage of screening and prevention were estimated. Predictors of receiving a TST at baseline, testing positive by TST and developing active TB were evaluated.RESULTS: In the present study, 2123 patients were observed for a total of 9412 person-years. Four hundred seventy-six (22.4%) patients were tested by TST within 90 days of first clinic visit. Having a first clinic visit during the highly active antiretroviral therapy era (OR 3.64; 95% CI 2.66 to 4.99), country of birth (ORs: Africa 3.11, Asia 2.79, Haiti 3.14, and Latin America and the Caribbean 2.38), time between HIV diagnosis and first visit (OR per one-year change 0.97; 95% CI 0.94 to 0.99) and previous antiretroviral exposure (OR 0.61; 95% CI 0.45 to 0.81) were independent predictors of receiving a TST at baseline. Of the 17 patients who developed active TB during follow-up, nine (53%) had no documented TSTs at baseline or during follow-up. Forty-one per cent of all TB patients and 56% of TB patients who were not screened were born in Canada.CONCLUSION: The administration of TSTs to newly diagnosed HIV patients was inconsistent and differential according to country of birth, among other factors, resulting in missed opportunities for TB prevention.

Tuberculosis screening in a dialysis unit: detecting latent tuberculosis infection is only half the problem

2014 ◽  
Vol 87 (4) ◽  
pp. 241-244 ◽  
Author(s):  
S.O. Brij ◽  
S.C. Beck ◽  
F. Kleemann ◽  
A.L. Jack ◽  
C. Wilkinson ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Tuberculosis Screening ◽  
Dialysis Unit

scholarly journals Lack of latent tuberculosis screening in HIV patients and delay in Anti-Retroviral Therapy initiation in HIV-TB co-infection: A 11-year study in an intermediate TB-burden country

2021 ◽  
Author(s):  
Vannesa Teng ◽  
Yan Ting Chua ◽  
Eunice Lai ◽  
Shilpa Mukherjee ◽  
Jessica Michaels ◽  
...  
Keyword(s):  
Latent Tuberculosis ◽  
Preventive Therapy ◽  
University Hospital ◽  
Care Hospital ◽  
Clinical Practices ◽  
Hiv Diagnosis ◽  
Hiv Patients ◽  
Tuberculosis Screening ◽  
National University ◽  
Latent Tb

Objectives Tuberculosis (TB) is a common infection in HIV patients. Our study aims to determine the prevalence and characteristics of HIV-TB co-infected patients in Singapore, a high-income, intermediate TB-burden country. Methods Retrospective data of 11-years was obtained from the National University Hospital (NUH), a quaternary care hospital and the National Centre for Infectious Diseases, the national HIV centre. Results From December 2005 to December 2016, 48 out of 819 HIV patients and 272 out of 3,196 HIV patients who were managed in NUH and TTSH respectively, were diagnosed with TB. 89.1% (n=285) were males and 2 (0.6%) were screened for latent TB on HIV diagnosis. The median age at TB diagnosis was 47.3 years old (Interquartile range, IQR 41-57). Mean CD4 count at TB diagnosis was 125.0 ± 153.9 cells/mm3. 124 (38.6%) patients had CD4 < 50 cells/mm3. 41.3% (n=132) of patients had HIV diagnosed at least 6 weeks before TB diagnosis, indicating an opportunity to initiate latent TB preventive therapy. 55.0% (n=176) had HIV and TB concomitantly diagnosed within 6 weeks whilst 2.25% (n=7) had TB diagnosed before HIV. Of those HIV-TB co-infected patients with CD4 < 50 cells/mm3, 18 (14.2%) had anti-retroviral therapy (ART) started ≤2 weeks. TB-related mortality was 5.3% (n=17) and 3.75% (n=12) were lost to follow-up. Conclusion There is a lack of latent TB screening in HIV patients and a delay in initiation of ART in HIV-TB patients with low CD4 counts in our study. Clinical practices can be further improved for the benefit of outcomes in HIV-TB patients.

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