Thorax
Volume 73, Issue 8, 2018

High prevalence of TB disease in contacts of adults with extrapulmonary TB (Article) (Open Access)

Wingfield T.* , Macpherson P. , Cleary P. , Ormerod L.P.
  • a Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, L69 7BE, United Kingdom, Department of Social Medicine, Karolinska Institutet, Stockholm, Sweden
  • b Department of Public Health, Cheshire and Merseyside Health Protection Team, Public Health England North West, Liverpool, United Kingdom, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
  • c Department of Public Health, Cheshire and Merseyside Health Protection Team, Public Health England North West, Liverpool, United Kingdom
  • d Lancashire Postgraduate School of Medicine, University of Central Lancashire, Preston, United Kingdom

Abstract

UK guidelines no longer recommend routine screening of household contacts of adult patients with extrapulmonary TB (EPTB). From 27 March 2012 to 28 June 2016, we investigated the prevalence of active TB disease in household contacts of 1023 EPTB index cases in North West England, and compared estimates with: Published new entrant migrant screening programme prevalence (∼147/100 000 person-years); London-based contact screening data (700/100 000 contacts screened); and National Institute for Health and Care Excellence (NICE) new entrant TB screening thresholds (TB prevalence >40/100 000 people). Active TB disease prevalence in EPTB contacts was 440/100 000 contacts screened, similar to UK new entrant screening programmes, London EPTB contact prevalence and >10 times NICE's threshold for new entrant screening. The decision to no longer recommend routine screening of EPTB contacts should be re-evaluated and cost-effectiveness analyses of screening strategies for EPTB contacts should be performed. © © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Author Keywords

tuberculosis clinical epidemiology

Index Keywords

descriptive research extrapulmonary tuberculosis household London Population Surveillance human priority journal screening test Young Adult Humans lung tuberculosis male England Tuberculosis, Pulmonary female clinical evaluation contact examination prevalence Contact Tracing Article Retrospective Studies major clinical study adult migration outcome assessment cohort analysis Transients and Migrants retrospective study practice guideline cost effectiveness analysis health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049231326&doi=10.1136%2fthoraxjnl-2017-210202&partnerID=40&md5=704b802ab0985505dc4c67993a233c31
DOI: 10.1136/thoraxjnl-2017-210202
ISSN: 00406376
Cited by: 2
Original Language: English