Strategies to reach and motivate migrant communities at high risk for TB to participate in a latent tuberculosis infection screening program: a community-engaged, mixed methods study among Eritreans

Latent tuberculosis infection (LTBI) can develop into tuberculosis (TB). The WHO requires the discovery and management of LTBI among high-risk groups. Health care workers (HCWs) constitute a high-risk group. Factors associated with LTBI among HCWs in Thailand need further study. The current study aimed to explore the factors related to LTBI among Thai HCWs. A hospital-based, matched case-control study was conducted. All cases and controls were HCWs at a tertiary hospital in northeastern Thailand. Between 2017 and 2019, a total of 85 cases of interferon-γ release assays (IGRAs)-proven LTBI, and 170 control subjects were selected from a hospital (two controls per case). The two recruited controls were individually matched with LTBI cases by sex and age (±5 years). Secondary data were obtained from the occupational health and safety office. Case HCWs had a higher proportion of significant factors than control HCWs (i.e., working closely with pulmonary TB—94.1% vs. 88.8%, and working in the area of aerosol-generating procedures (AGPs) 81.2% vs. 69.4%). The bivariate conditional logistic regression showed that the occurrence of LTBI in HCWs was statistically significant (p-value < 0.05), particularly with respect to: workplaces of AGPs (crude OR = 1.90, 95% CI: 1.01–3.58, p = 0.041); among HCWs performing AGPs (crude OR = 2.04, 95% CI: 1.20, 3.48, p = 0.007); and, absent Bacille Calmette-Guérin (BCG) scar (crude OR = 2.59, 95% CI: 1.50–4.47, p = 0.001). Based on the multivariable conditional logistics analysis, HCWs who performed AGPs while contacting TB cases had a statistically significant association with LTBI (adjusted OR = 1.82, 95% CI: 1.04–3.20, p = 0.035). HCWs who reported the absence of a BCG scar had a statistically significant association with LTBI (adjusted OR = 2.49, 95% CI: 1.65–5.36, p = 0.001), whereas other factors including close contact with TB (adjusted OR = 2.44, 95% CI: 0.74, 8.09, p = 0.123) were not significantly associated with LTBI. In conclusion, HCWs who performed AGPs and were absent a BCG scar had a significant association with LTBI, while other factors played a less critical role.

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Implementation of latent tuberculosis infection screening and treatment among newly arriving immigrants in the Netherlands: A mixed methods pilot evaluation

PLoS ONE ◽

10.1371/journal.pone.0219252 ◽

2019 ◽

Vol 14 (7) ◽

pp. e0219252 ◽

Cited By ~ 5

Author(s):

Ineke Spruijt ◽

Connie Erkens ◽

Jeanine Suurmond ◽

Erik Huisman ◽

Marga Koenders ◽

...

Keyword(s):

Mixed Methods ◽

The Netherlands ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculosis Infection

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

PLoS ONE ◽

10.1371/journal.pone.0110104 ◽

2014 ◽

Vol 9 (11) ◽

pp. e110104 ◽

Cited By ~ 16

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

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Interferon-γ releasing assay versus tuberculin skin testing for latent tuberculosis infection in targeted screening programs for high risk immigrants

Infection ◽

10.1007/s15010-010-0015-2 ◽

2010 ◽

Vol 38 (3) ◽

pp. 195-204 ◽

Cited By ~ 16

Author(s):

G. Orlando ◽

S. Merli ◽

L. Cordier ◽

F. Mazza ◽

G. Casazza ◽

...

Keyword(s):

High Risk ◽

Latent Tuberculosis Infection ◽

Skin Testing ◽

Latent Tuberculosis ◽

Interferon Γ ◽

Tuberculosis Infection ◽

Tuberculin Skin Testing ◽

Screening Programs ◽

Targeted Screening

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Use of a scoring strategy to determine clinical risk of progression and risk group-specific treatment adherence in subjects with latent tuberculosis infection

10.1101/207852 ◽

2017 ◽

Author(s):

Michael Scolarici ◽

Ken Dekitani ◽

Ling Chen ◽

Marcia Sokol-Anderson ◽

Daniel F Hoft ◽

...

Keyword(s):

High Risk ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Standard Of Care ◽

Treatment Completion ◽

Risk Groups ◽

Tuberculosis Infection ◽

Current Standard ◽

Clinical Risk ◽

The Us

ABSTRACTBackgroundAnnual incidence of active tuberculosis (TB) cases has plateaued in the US from 2013-2015. Most cases are from reactivation of latent tuberculosis infection (LTBI). A likely contributor is suboptimal LTBI treatment completion rates in subjects at high risk of developing active TB. It is unknown whether these patients are adequately identified and treated under current standard of care.MethodsIn this study, we sought to retrospectively assess the utility of an online risk calculator (tstin3d.com) in determining probability of LTBI and defining the characteristics and treatment outcomes of Low: 0-<10%, Intermediate: 10-<50% and High: 50-100% risk groups of asymptomatic subjects with LTBI seen between 2010-2015.Results51(41%), 46 (37%) and 28 (22%) subjects were in Low, Intermediate and High risk groups respectively. Tstin3d.com was useful in determining the probability of LTBI in tuberculin skin test positive US born subjects. Of 114 subjects with available treatment information, overall completion rate was 61% and rates of completion in Low (60%), Intermediate (63%) and High (57%) risk groups were equivalent. 75% subjects in the 3HP group completed treatment compared to 58% in the INH group. Provider documentation of important clinical risk factors was often incomplete. Logistic regression analysis showed no clear trends of treatment completion being associated with assessment of a risk factor.ConclusionThese findings suggest tstin3d.com could be utilized in the US setting for risk stratification of patients with LTBI and select treatment based on risk. Current standard of care practice leads to subjects in all groups finishing treatment at equivalent rates.

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