scholarly journals Estimating the prevalence of latent tuberculosis in a low-incidence setting: Australia

2018 ◽  
Vol 52 (6) ◽  
pp. 1801218 ◽  
Author(s):  
Katie Dorothy Dale ◽  
James McCracken Trauer ◽  
Pete J. Dodd ◽  
Rein M.G.J. Houben ◽  
Justin Timothy Denholm
Keyword(s):  
Census Data ◽  
Health Planning ◽  
Latent Tuberculosis ◽  
Absolute Number ◽  
Migrant Populations ◽  
High Incidence ◽  
Ltbi Prevalence ◽  
Australian Census ◽  
Latent Tb ◽  
Low Incidence

Migration is a key driver of tuberculosis (TB) in many low-incidence settings, with the majority of TB cases attributed to reactivation of latent TB (LTBI) acquired overseas. A greater understanding of LTBI risk in heterogeneous migrant populations would aid health planning. We aimed to estimate the LTBI prevalence and distribution among locally born and overseas-born Australians.Annual risks of TB infection estimates were applied to population cohorts (by country of birth, year of arrival and age) in Australian census data in 2006, 2011 and 2016.Both the absolute number and proportion of Australian residents with LTBI increased from 4.6% (interquartile range (IQR) 4.2–5.2%) in 2006 to 5.1% (IQR 4.7–5.5%) in 2016, due to the increasing proportion of the population born overseas (23.8% in 2006 to 28.3% in 2016). Of all residents estimated to have LTBI in 2016; 93.2% were overseas born, 21.6% were aged <35 years and 34.4% had migrated to Australia since 2007.The overall prevalence of LTBI in Australia is low. Some residents, particularly migrants from high-incidence settings, may have considerably higher risk of LTBI, and these findings allow for tailored public health interventions to reduce the risk and impact of future TB disease.

scholarly journals Screening for tuberculosis in migrants and visitors from high-incidence settings: present and future perspectives

2018 ◽  
Vol 52 (1) ◽  
pp. 1800591 ◽  
Author(s):  
Claudia C. Dobler ◽  
Greg J. Fox ◽  
Paul Douglas ◽  
Kerri A. Viney ◽  
Faiz Ahmad Khan ◽  
...  
Keyword(s):  
Foreign Born ◽  
Screening Practices ◽  
Migrant Populations ◽  
Long Duration ◽  
Increased Risk ◽  
High Incidence ◽  
Latent Tb ◽  
Low Incidence ◽  
Latent Tb Infection

In most settings with a low incidence of tuberculosis (TB), foreign-born people make up the majority of TB cases, but the distribution of the TB risk among different migrant populations is often poorly quantified. In addition, screening practices for TB disease and latent TB infection (LTBI) vary widely. Addressing the risk of TB in international migrants is an essential component of TB prevention and care efforts in low-incidence countries, and strategies to systematically screen for, diagnose, treat and prevent TB among this group contribute to national and global TB elimination goals.This review provides an overview and critical assessment of TB screening practices that are focused on migrants and visitors from high to low TB incidence countries, including pre-migration screening and post-migration follow-up of those deemed to be at an increased risk of developing TB. We focus mainly on migrants who enter the destination countryviaapplication for a long-stay visa, as well as asylum seekers and refugees, but briefly consider issues related to short-term visitors and those with long-duration multiple-entry visas. Issues related to the screening of children and screening for LTBI are also explored.

scholarly journals Prevalence of latent tuberculosis infection and feasibility of TB preventive therapy among Thai prisoners: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sivaporn Gatechompol ◽  
Weerakit Harnpariphan ◽  
Ruamthip Supanan ◽  
Gompol Suwanpimolkul ◽  
Jiratchaya Sophonphan ◽  
...  
Keyword(s):  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Preventive Therapy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ltbi Prevalence ◽  
History Of ◽  
Chest X Ray ◽  
Latent Tb ◽  
Latent Tb Infection

Abstract Background Prisons are considered as major reservoirs for tuberculosis. Preventive therapy for latent TB infection (LTBI) is an adjunctive strategy to control TB. However, LTBI data in Thai prisoners is limited. This study assessed the prevalence of LTBI and feasibility of isoniazid preventive therapy (IPT). Methods A cross-sectional study was conducted among prisoners in Klong Prem Central Prison, Bangkok. Participants were screened for active TB by questionnaire and chest X-ray. LTBI was evaluated by Tuberculin skin test (TST) and QuantiFERON-TB Gold Plus (QFTP) among subgroup. Participants with positive TST or QFTP were considered to have LTBI. Participants with LTBI were offered IPT. Results From August 2018–November 2019, 1002 participants were analyzed. All participants were male with a median age of 38 (IQR 32–50) years. LTBI identified by either TST/QFTP was present in 466 (46.5%) participants. TST was positive in 359 (36%) participants. In the subgroup of 294 participants who had both TST and QFTP results, 181/294 (61.6%) tested positive by QFTP. Agreement between TST and QFTP was 55.1% (Kappa = 0.17). The risk factors associated with LTBI were previous incarceration (aOR 1.53, 95%CI, 1.16–2.01, p = 0.002), history of prior active TB (aOR 3.02, 95%CI, 1.74–5.24, p < 0.001) and duration of incarceration ≥10 years (aOR 1.86, 95%CI, 1.24–2.79, p = 0.003). Majority of LTBI participants (82%) agreed to take IPT. Three hundred and 56 (93%) participants completed treatment whereas 27 (7%) participants discontinued IPT due to the side effects of INH. Conclusion This is the first study to evaluate the prevalence of LTBI and feasibility of IPT among Thai prisoners. LTBI prevalence in male prisoners in Thailand is high. LTBI screening and treatment should be implemented together with other preventive components.

scholarly journals National roll-out of latent tuberculosis testing and treatment for new migrants in England: a retrospective evaluation in a high-incidence area

2018 ◽  
Vol 51 (1) ◽  
pp. 1701226 ◽  
Author(s):  
Miranda G. Loutet ◽  
Matthew Burman ◽  
Nivenka Jayasekera ◽  
Duncan Trathen ◽  
Susan Dart ◽  
...  
Keyword(s):  
Latent Tuberculosis ◽  
Country Of Birth ◽  
Factors Associated ◽  
Ltbi Screening ◽  
Treatment Uptake ◽  
High Incidence ◽  
Testing Uptake ◽  
Low Incidence ◽  
Ltbi Testing ◽  
High Incidence Area

Latent tuberculosis infection (LTBI) screening is an important intervention for tuberculosis (TB) elimination in low-incidence countries and is, therefore, a key component of England's TB control strategy. This study describes outcomes from a LTBI screening programme in a high-incidence area to inform national LTBI screening in England and other low-incidence countries.We conducted a retrospective cohort study of LTBI screening among eligible migrants (from high-incidence countries and entered the UK within the last 5 years), who were identified at primary-care clinics in Newham, London between August 2014 and August 2015. Multivariable logistic regression was used to identify factors associated with LTBI testing uptake, interferon-γ release assay (IGRA) positivity and treatment uptake.40% of individuals offered LTBI screening received an IGRA test. The majority of individuals tested were 16–35 years old, male and born in India, Bangladesh or Pakistan. Country of birth, smoking status and co-morbidities were associated with LTBI testing uptake. IGRA positivity was 32% among those tested and was significantly associated with country of birth, age, sex and co-morbidities.This study identifies factors associated with screening uptake, IGRA positivity and treatment uptake, and improves understanding of groups that should be supported to increase acceptability of LTBI testing and treatment in the community.

Evaluation of the latent tuberculosis screening and treatment strategy for asylum seekers in Stockholm, Sweden 2015–2018 - a record linkage study of the care cascade

2020 ◽  
pp. 2002255
Author(s):  
Joanna Nederby Öhd ◽  
Maria-Pia Hergens ◽  
Yauheni Luksha ◽  
Charlotte Buxbaum ◽  
Jad Shedrawy ◽  
...  
Keyword(s):  
Host Country ◽  
Record Linkage ◽  
Asylum Seekers ◽  
Latent Tuberculosis ◽  
Linkage Study ◽  
Tuberculosis Screening ◽  
Care Cascade ◽  
High Incidence ◽  
Latent Tb ◽  
Latent Tb Infection

In many countries with low tuberculosis (TB) incidence (<10/100,000) a high proportion of cases originate from latent TB infection (LTBI) reactivation among migrants from high-incidence countries (≥100/100,000) who have been infected before arrival in the host country [1, 2]. Consequently, LTBI screening and management for migrants is an important intervention to reduce TB incidence in those countries [1, 3, 4].

scholarly journals Universal screening for latent and active tuberculosis (TB) in asylum seeking children, Bochum and Hamburg, Germany, September 2015 to November 2016

2018 ◽  
Vol 23 (12) ◽  
Author(s):  
Maya Mueller-Hermelink ◽  
Robin Kobbe ◽  
Benedikt Methling ◽  
Cornelius Rau ◽  
Ulf Schulze-Sturm ◽  
...  
Keyword(s):  
Travel Time ◽  
Interferon Gamma Release Assay ◽  
Foreign Born ◽  
Screening Strategies ◽  
Ltbi Prevalence ◽  
Risk Of Progression ◽  
Release Assay ◽  
Latent Tb ◽  
Low Incidence ◽  
Latent Tb Infection

Background In Germany, the incidence of tuberculosis (TB) in children has been on the rise since 2009. High numbers of foreign-born asylum seekers have contributed considerably to the disease burden. Therefore, effective screening strategies for latent TB infection (LTBI) and active TB in asylum seeking children are needed. Aim: Our aim was to investigate the prevalence of LTBI and active TB in asylum seeking children up to 15 years of age in two geographic regions in Germany. Methods: Screening for TB was performed in children in asylum seeker reception centres by tuberculin skin test (TST) or interferon gamma release assay (IGRA). Children with positive results were evaluated for active TB. Additionally, country of origin, sex, travel time, TB symptoms, TB contact and Bacille Calmette-Guérin (BCG) vaccination status were registered. Results: Of 968 screened children 66 (6.8%) had TB infection (58 LTBI, 8 active TB). LTBI prevalence was similar in children from high (Afghanistan) and low (Syria) incidence countries (8.7% vs 6.4%). There were no differences regarding sex, age or travel time between infected and non-infected children. Children under the age of 6 years were at higher risk of progression to active TB (19% vs 2% respectively, p=0,07). Most children (7/8) with active TB were asymptomatic at the time of diagnosis. None of the children had been knowingly exposed to TB. Conclusions: Asylum seeking children from high and low incidence countries are both at risk of developing LTBI or active TB. Universal TB screening for all asylum seeking children should be considered.

scholarly journals Lawsuits against plastic surgeons: Does locale affect incidence of claims?

2007 ◽  
Vol 15 (3) ◽  
pp. 155-157 ◽  
Author(s):  
Jonathan L Kaplan ◽  
Warren C Hammert ◽  
James E Zin
Keyword(s):  
United States ◽  
Emergency Room ◽  
Plastic Surgery ◽  
Medical Malpractice ◽  
The United States ◽  
Absolute Number ◽  
Malpractice Claims ◽  
High Incidence ◽  
Medical Malpractice Claims ◽  
Geographical Locations

Background Physicians continue to practice in a very litigious environment. Some physicians try to mitigate their exposure to lawsuits by avoiding geographical locations known for their high incidence of medical malpractice claims. Not only are certain areas of the United States known to have a higher incidence of litigation, but it is also assumed that certain areas of the hospital incur a greater liability. There seems to be a medicolegal dogma suggesting a higher percentage of malpractice claims coming from patients seen in the emergency room (ER), as well as higher settlements for ER claims. Objective To determine if there is any validity to the dogma that a higher percentage of malpractice claims arise from the ER. Methods An analysis of common plastic surgery consults that result in malpractice claims was performed. The location where the basis for the lawsuit arose – the ER, office (clinic) or the operating room (OR) – was evaluated. The value of the indemnity paid and whether its value increased or decreased based on the location of the misadventure was evaluated. Results According to the data, which represented 60% of American physicians, there was a larger absolute number of malpractice claims arising from the OR, not the ER. However, the highest average indemnity was paid for cases involving amputations when the misadventure originated in the ER. Conclusions The dogma that a greater percentage of lawsuits come from incidents arising in the ER is not supported. However, depending on the patient's injury and diagnosis, a lawsuit from the ER can be more costly than one from the OR.

scholarly journals Spatial distribution and risk assessment of toxic metals in agricultural soils from endemic nasopharyngeal carcinoma region in South China

2020 ◽  
Vol 12 (1) ◽  
pp. 568-579
Author(s):  
Liping Mo ◽  
Yongzhang Zhou ◽  
Gnanachandrasamy Gopalakrishnana ◽  
Xingyuan Li
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
South China ◽  
Toxic Metals ◽  
Agricultural Soils ◽  
Hazard Index ◽  
Toxic Metal ◽  
Carcinogenic Risk ◽  
Pollution Indices ◽  
High Incidence ◽  
Low Incidence

AbstractSihui city (South China) is much affected by nasopharyngeal carcinoma (NPC). To investigate the relationships between the toxic metals in soil and NPC incidence in Sihui, 119 surface soil samples were collected from agricultural fields and analyzed. The soil As–Cr contents in Longjiang (high-incidence area) are significantly lower than those in Weizheng and Jianglin (low-incidence areas), whereas the soil Pb content in Longjiang is significantly higher than that in Weizheng. The Nemerow pollution indices (PIN) of soils decrease in the order of Jianglin > Weizheng > Longjiang. The enrichment factor (EF) of Cd indicates that the Cd enrichment is contributed by human activities. Potential toxic metal-related ecological risk values decrease in the order of Jianglin > Weizheng > Longjiang. The mean hazard index (HI) value of Longjiang was lower than those of Weizheng and Jianglin. There are no adverse noncarcinogenic health effects of soil toxic metals to adults in the study areas. Carcinogenic risks of As and Cr via ingestion and dermal contact and total carcinogenic risk are within the warning range, from 10−6 to 10−4. Hence, we suggest that toxic metals in the soil may not be major geochemical carcinogenic factors of high NPC incidence in Sihui.

scholarly journals Cytokine Biosignature of Active and Latent Mycobacterium Tuberculosis Infection in Children

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 517
Author(s):  
Magdalena Druszczynska ◽  
Michal Seweryn ◽  
Sebastian Wawrocki ◽  
Magdalena Kowalewska-Pietrzak ◽  
Anna Pankowska ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Inflammatory Mediators ◽  
Latent Tuberculosis ◽  
Serum Levels ◽  
Diagnostic Tools ◽  
Mycobacterium Tuberculosis Infection ◽  
Only Children ◽  
Latent Tb ◽  
Ifn Γ ◽  
Multiplex Bead

None of the currently used diagnostic tools are efficient enough in diagnosing Mycobacterium tuberculosis (M.tb) infection in children. The study was aimed to identify cytokine biosignatures characterizing active and latent tuberculosis (TB) in children. Using a multiplex bead-based technology, we analyzed the levels of 53 Th17-related cytokines and inflammatory mediators in sera from 216 BCG-vaccinated children diagnosed with active TB (TB) or latent TB (LTBI) as well as uninfected controls (HC). Children with active TB, compared to HC children, showed reduced serum levels of IL-17A, MMP-2, OPN, PTX-3, and markedly elevated concentrations of APRIL/TNFSF13. IL-21, sCD40L, MMP-2, and IL-8 were significantly differentially expressed in the comparisons between groups: (1) HC versus TB and LTBI (jointly), and (2) TB versus LTBI. The panel consisting of APRIL/TNFSF13, sCD30/TNFRSF8, IFN-α2, IFN-γ, IL-2, sIL-6Rα, IL-8, IL-11, IL-29/IFN-λ1, LIGHT/TNFSF14, MMP-1, MMP-2, MMP-3, osteocalcin, osteopontin, TSLP, and TWEAK/TNFSF12 possessed a discriminatory potential for the differentiation between TB and LTBI children. Serum-based host biosignatures carry the potential to aid the diagnosis of childhood M.tb infections. The proposed panels of markers allow distinguishing not only children infected with M.tb from uninfected individuals but also children with active TB from those with latent TB.

scholarly journals Could MicroRNAs Be Useful Tools to Improve the Diagnosis and Treatment of Rare Gynecological Cancers? A Brief Overview

2021 ◽  
Vol 22 (8) ◽  
pp. 3822
Author(s):  
Riccardo Di Fiore ◽  
Sherif Suleiman ◽  
Francesca Pentimalli ◽  
Sharon A. O’Toole ◽  
John J. O’Leary ◽  
...  
Keyword(s):  
Female Genital Tract ◽  
Germ Cell Tumors ◽  
Delayed Diagnosis ◽  
Public Health Issue ◽  
Gene Promoters ◽  
Gynecological Cancers ◽  
High Incidence ◽  
Low Incidence ◽  
Diagnosis Therapy ◽  
Malignant Germ Cell Tumors

Gynecological cancers pose an important public health issue, with a high incidence among women of all ages. Gynecological cancers such as malignant germ-cell tumors, sex-cord-stromal tumors, uterine sarcomas and carcinosarcomas, gestational trophoblastic neoplasia, vulvar carcinoma and melanoma of the female genital tract, are defined as rare with an annual incidence of <6 per 100,000 women. Rare gynecological cancers (RGCs) are associated with poor prognosis, and given the low incidence of each entity, there is the risk of delayed diagnosis due to clinical inexperience and limited therapeutic options. There has been a growing interest in the field of microRNAs (miRNAs), a class of small non-coding RNAs of ∼22 nucleotides in length, because of their potential to regulate diverse biological processes. miRNAs usually induce mRNA degradation and translational repression by interacting with the 3′ untranslated region (3′-UTR) of target mRNAs, as well as other regions and gene promoters, as well as activating translation or regulating transcription under certain conditions. Recent research has revealed the enormous promise of miRNAs for improving the diagnosis, therapy and prognosis of all major gynecological cancers. However, to date, only a few studies have been performed on RGCs. In this review, we summarize the data currently available regarding RGCs.

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