scholarly journals The burden and predictors of latent tuberculosis infection among immigrants in South Korea: a retrospective cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Yu ◽  
Dawoon Jeong ◽  
Hongjo Choi
Keyword(s):  
South Korea ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Prevalence Ratio ◽  
Tuberculosis Infection ◽  
Korean Population ◽  
Cross Sectional ◽  
Ltbi Screening ◽  
Korean Diaspora ◽  
Ltbi Prevalence

Abstract Background Approximately one-fourth of the global population is latently infected with Mycobacterium tuberculosis. An understanding of the burden of latent tuberculosis infection (LTBI) among immigrants compared with the general Korean population should be the first step in identifying priority groups for LTBI diagnosis and treatment. The study aimed to compute the age-standardized LTBI prevalence and predictors among immigrants with LTBI in South Korea. Methods In 2018, the Korea Disease Control and Prevention Agency implemented a pilot LTBI screening project for immigrants using a chest radiography and the QuantiFERON Gold In-Tube assay. A standardized prevalence ratio (SPR) was computed to compare the LTBI burden in immigrants and the general Korean population. Results During the duration of the project, a total of 8108 immigrants (5134 males and 2974 females) underwent LTBI screening. The SPR of 1.547 (95% confidence interval [CI] 1.468–1.629) in males and 1.261 (95% CI 1.177–1.349) in females were both higher than the Korean reference population. Furthermore, among the immigrants, those aged < 40 years and Korean diaspora visa holders had a higher SPR. Conclusion This study found a higher LTBI prevalence among immigrant population in South Korea compared to that in the general Korean population, and the SPR was higher among those aged < 40 years and the Korean diaspora. The findings can be used as baseline evidence for including immigrants in South Korea in the at-risk group with a priority need for LTBI screening and treatment.

scholarly journals POS1157 CONCORDANCE BETWEEN THE QUANTIFERON-TB GOLD IN-TUBE AND TUBERCULIN TEST FOR THE DIAGNOSIS OF LATENT TUBERCULOSIS INFECTION IN PATIENTS WITH RHEUMATIC DISEASES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 857.1-857
Author(s):  
C. Pávez Perales ◽  
A. Quiles Roger ◽  
E. Grau García ◽  
M. De la Rubia Navarro ◽  
S. Leal Rodriguez ◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculin Test ◽  
Tuberculosis Infection ◽  
Categorical Variables ◽  
Ltbi Screening ◽  
Kappa Test ◽  
Receive Treatment

Background:Patients with rheumatic diseases (RD) are at higher risk of latent tuberculosis infection (LTBI) reactivation. To detect and treat it before starting treatment, especially with biological therapies, decrease the reactivation risk. Diagnosis is carried out by the tuberculin skin test (TST) or interferon-gamma release assays (IGRAs), IGRAs might be more specific and sensitive.Objectives:We aim to analyze the concordance between QuantiFERON-TB Gold In-Tube (QTF) and TST for the diagnosis of LTBI in patients with rheumatic diseases.Methods:A retrospective observational study was conducted including patients diagnosed with RD screened for LTBI with both TST and QTF (2014-2018). Demographical and clinical variables at screening and at follow-up were collected. The concordance between both tests has been estimated as categorical variables using Cohen´s Kappa test, considering “poor” if it is ≤ 0,20; “low” if 0,20 < k ≤ 0,40, “moderate” if 0,40 < k ≤ 0,60, “substantial” if 0,60 < k ≤ 0,80 and “optimal” if k > 0,80.Results:167 patients were included (57% women) with a mean age of 52±16 years. 42% of them had systemic autoimmune diseases, 22% spondyloarthropathies and 36% other RD. 2 had history of past active tuberculosis (TB). At the time of screening, 46.11% were treated with GC.LTBI was diagnosed in 35 patients: 15 had both QTF and TST positive, 16 only QTF positive and 4 only TST positive. 12 from 31 QTF positive patients were treated with GC at the time of screening. 3 from 19 TST positive patients were treated with GC at the time of screening.After LTBI screening 62 patients received biological treatment, 4 of them had both test positive, 6 only QTF positive and 2 only TST positive. 11 received LTBI treatment according to the hospital protocol (isoniazid for 6 to 9 months). 10 completed treatment, 1 did not because of intolerance and did not receive other treatment. 1 patient with only TST positive was considered a false positive and did not receive treatment. During follow-up no TB reactivation was reported.23 patients with LBTI received treatment other than biological therapy during follow-up, of them 8 received LBTI treatment. There was no TB reactivation during follow up.The Kappa concordance between QTF and TST was estimated: moderated in the whole sample, poor in the patients treated with GC at screening, and substantial when the patients treated with GC at screening were excluded. Results are shown in Table 1.Table 1.Kappa concordance between QTF and TST.Conclusion:QTF seems to be the most appropriate LTBI screening test in patients with RD treated with GC. Screening and treatment of LTBI in patients with RD treated with or without biological agents was effective in reducing TB reactivation.Disclosure of Interests:None declared.

scholarly journals Duration of Exposure Among Close Contacts of Patients With Infectious Tuberculosis and Risk of Latent Tuberculosis Infection

2020 ◽  
Vol 71 (7) ◽  
pp. 1627-1634
Author(s):  
Mary R Reichler ◽  
Awal Khan ◽  
Yan Yuan ◽  
Bin Chen ◽  
James McAuley ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Multivariable Analysis ◽  
Latent Tuberculosis ◽  
Index Patient ◽  
The United States ◽  
Tuberculosis Infection ◽  
Ltbi Prevalence ◽  
Male Sex ◽  
Positive Index ◽  
Close Contacts

Abstract Background Predictors of latent tuberculosis infection (LTBI) among close contacts of persons with infectious tuberculosis (TB) are incompletely understood, particularly the number of exposure hours. Methods We prospectively enrolled adult patients with culture-confirmed pulmonary TB and their close contacts at 9 health departments in the United States and Canada. Patients with TB were interviewed and close contacts were interviewed and screened for TB and LTBI during contact investigations. Results LTBI was diagnosed in 1390 (46%) of 3040 contacts, including 624 (31%) of 2027 US/Canadian-born and 766 (76%) of 1013 non-US/Canadian-born contacts. In multivariable analysis, age ≥5 years, male sex, non-US/Canadian birth, smear-positive index patient, and shared bedroom with an index patient (P &lt; .001 for each), as well as exposure to &gt;1 index patient (P &lt; .05), were associated with LTBI diagnosis. LTBI prevalence increased with increasing exposure duration, with an incremental prevalence increase of 8.2% per 250 exposure hours (P &lt; .0001). For contacts with &lt;250 exposure hours, no difference in prevalence was observed per 50 exposure hours (P = .63). Conclusions Hours of exposure to a patient with infectious TB is an important LTBI predictor, with a possible risk threshold of 250 hours. More exposures, closer exposure proximity, and more extensive index patient disease were additional LTBI predictors.

scholarly journals 1376. Physician Practice Patterns for Screening and Treatment of Latent Tuberculosis Infection in the South Asian Population in Central New Jersey

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S499-S500
Author(s):  
Nupur Gulati ◽  
Sri Ram Pentakota ◽  
Kristina N Feja ◽  
Bishakha Ghoshal ◽  
Rajita Bhavaraju ◽  
...  
Keyword(s):  
New Jersey ◽  
South Asian ◽  
Outcome Measure ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Medical Graduate ◽  
Chi Square ◽  
Ltbi Screening

Abstract Background New Jersey (NJ) has a significant burden of tuberculosis (TB) cases (ranked 8th in the United States) and 22% of the cases are among foreign-born (FB) individuals. We have approximately 33% FB residents in our targeted counties in Central NJ of whom 43% are originally from high TB burden areas of South Asia. Central NJ is home to the county with the second highest TB case rate in NJ. Latent tuberculosis infection (LTBI) treatment remains a key component of the World Health Organization TB elimination strategy. We sought to survey community physicians about their LTBI screening and treatment practices in South Asian (SA) patients. Methods An IRB-approved anonymous survey was distributed online to practicing staff physicians at local hospitals over a 2-month period. The primary outcome measure was whether physicians appropriately screen for LTBI. A secondary outcome measure was whether follow-up after medication initiation was provided. Predictors measured included: age, gender, self -identification of physician as SA, years in practice, and if they were a foreign medical graduate (FMG). Descriptive statistics were provided using counts and proportions. Chi-square tests were used for bivariate analyses to look for factors associated with LTBI screening and treatment. Results A total of 218 physicians responded to the survey; of whom, 137 identified themselves as primary care physicians (i.e., pediatrics (62%), internal medicine (30%), or family medicine (8%)). About half of them were FMG and 40% identify themselves as SA. Three out of four of these physicians (n = 101) indicated they routinely screen their patients for LTBI. Bivariate analyses using chi-square did not find any statistically significant associations with LTBI screening. A quarter of the physicians screened with an IGRA and 60% reported always offering treatment for LTBI. Isoniazid was the most common medication prescribed. A majority of respondents did not report prescribing Rifampin or Rifapentine. Follow-up after initiation of treatment was provided at least every other month by 52.7% of physicians. Conclusion There is wide variability in LTBI screening, treatment, and follow-up among our physician sample. Physicians have not yet adopted newer treatment regimens suggesting the need for an educational intervention. Disclosures All authors: No reported disclosures.

scholarly journals Latent Tuberculosis Infection among a Large Cohort of Medical Students at a Teaching Hospital in Italy

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Paolo Durando ◽  
Cristiano Alicino ◽  
Andrea Orsi ◽  
Ilaria Barberis ◽  
Chiara Paganino ◽  
...  
Keyword(s):  
Medical Students ◽  
Teaching Hospital ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Large Cohort ◽  
Tuberculosis Infection ◽  
Interferon Gamma Release Assay ◽  
Cross Sectional ◽  
Professional Exposure

The surveillance of latent tuberculosis infection (LTBI) in both healthcare workers and healthcare students is considered fundamental for tuberculosis (TB) prevention. The aim of the present study was to estimate LTBI prevalence and evaluate potential risk-factors associated with this condition in a large cohort of medical students in Italy. In a cross-sectional study, performed between March and December 2012, 1511 eligible subjects attending the Medical School of the University of Genoa, trained at the IRCCS San Martino-IST Teaching Hospital of Genoa, were actively called to undergo the tuberculin skin test (TST). All the TST positive cases were confirmed with an interferon-gamma release assay (IGRA). A standardized questionnaire was collected for multivariate risk analysis. A total of 1302 (86.2%) students underwent TST testing and completed the questionnaire. Eleven subjects (0.8%) resulted TST positive and LTBI diagnosis was confirmed in 2 (0.1%) cases. Professional exposure to active TB patients (OR 21.7, 95% CI 2.9–160.2;Pvalue 0.003) and previous BCG immunization (OR 28.3, 95% CI 3.0–265.1;Pvalue 0.003) are independently associated with TST positivity. Despite the low prevalence of LTBI among Italian medical students, an occupational risk of TB infection still exists in countries with low circulation ofMycobacterium tuberculosis.

scholarly journals Gender Disparities in Latent Tuberculosis Infection in High-Risk Individuals: A Cross-Sectional Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (11) ◽  
pp. e110104 ◽  
Author(s):  
Wen-Ying Ting ◽  
Shiang-Fen Huang ◽  
Ming-Che Lee ◽  
Yung-Yang Lin ◽  
Yu-Chin Lee ◽  
...  
Keyword(s):  
High Risk ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Gender Disparities ◽  
Tuberculosis Infection ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Systematic review of latent tuberculosis infection research to inform programmatic management in Ireland

2021 ◽  
Author(s):  
James O’Connell ◽  
Eoghan de Barra ◽  
Samuel McConkey
Keyword(s):  
Systematic Review ◽  
Latent Tuberculosis Infection ◽  
Meta Analysis ◽  
Latent Tuberculosis ◽  
Risk Groups ◽  
Tuberculosis Infection ◽  
World Health ◽  
People Living With Hiv ◽  
Knowledge Gaps ◽  
Ltbi Screening

AbstractThe World Health Organisation (WHO) End Tuberculosis (TB) Strategy and the WHO Framework Towards Tuberculosis Elimination in Low Incidence Countries state that latent tuberculosis infection (LTBI) screening and treatment in selected high-risk groups is a priority action to eliminate TB. The European Centre for Disease Prevention and Control (ECDC) advises that this should be done through high-quality programmatic management, which they describe as having six key components. The research aim was to systematically review the literature to identify what is known about the epidemiology of LTBI and the uptake and completion of LTBI screening and treatment in Ireland to inform the programmatic management of LTBI nationally. A systematic literature review was performed according to a review protocol and reported in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Twenty-eight studies were eligible for inclusion and described LTBI screening or treatment performed in one of five contexts, pre-biologic or other immunosuppression screening, people living with HIV, TB case contacts, other vulnerable populations, or healthcare workers. The risk of bias across studies with regard to prevalence of LTBI was generally high. One study reported a complete cascade of LTBI care from screening initiation to treatment completion. This systematic review has described what published research there is on the epidemiology and cascade of LTBI care in Ireland and identified knowledge gaps. A strategy for addressing these knowledge gaps has been proposed.

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