International Journal of Tuberculosis and Lung Disease
Volume 21, Issue 2, 2017, Pages 175-180

Latent tuberculous screening of recent migrants attending language classes: A cohort study and cost analysis (Article)

Usdin M.* , Dedicoat M. , Gajraj R. , Harrison P. , Kaur H. , Duffield K. , Walker C.-L. , Akram Y. , Aiyedun V. , Mohamed H. , Zenner D.
  • a PHE Centre for Infectious Disease Surveillance and Control, 61 Colindale Avenue, London, NW9 5EQ, United Kingdom
  • b Heart of England Foundation Trust, Birmingham, United Kingdom
  • c PHE West Midlands, Birmingham, United Kingdom
  • d South and City College Birmingham, Birmingham, United Kingdom
  • e Birmingham and Solihull TB Service, Heart of England National Health Service Trust, Birmingham, United Kingdom
  • f Centre for Infectious Disease Surveillance and Control, PHE, London, United Kingdom
  • g Centre for Infectious Disease Surveillance and Control, PHE, London, United Kingdom
  • h Centre for Infectious Disease Surveillance and Control, PHE, London, United Kingdom
  • i Centre for Infectious Disease Surveillance and Control, PHE, London, United Kingdom
  • j Centre for Infectious Disease Surveillance and Control, PHE, London, United Kingdom
  • k PHE Centre for Infectious Disease Surveillance and Control, 61 Colindale Avenue, London, NW9 5EQ, United Kingdom, Centre for Infectious Disease Epidemiology, University College London, London, United Kingdom, National Institute for Health Research Health Protection Research Unit in Respiratory Infections, Imperial College London, London, United Kingdom

Abstract

S E T T ING: England's national tuberculosis (TB) strategy recommends testing for and treatment of latent tuberculous infection (LTBI) among new migrants. Programmatic testing occurs in primary care, which may be inaccessible for some individuals. Current strategies could therefore be complemented by screening in other settings. OBJECTIVE : To investigate the feasibility and effectiveness of LTBI screening in a community college. DE S IGN: A cohort study using observational data collected during the pilot study. Eligible students from high-incidence countries provided consent and were tested with a single-step interferon-gamma release assay (IGRA) and enrolled. We used single and multivariable analyses to estimate screening effectiveness and to explore different subgroups. We included costs from a UK National Health Service perspective. RESULT S : Screening uptake was 75% and treatment completion was 85%. Of 440 students, 71 (16%) were LTBI-positive; two had active TB. There was an association of positivity with age and incidence in the country of origin. Three incidence thresholds met our criteria for screening: countries with .40, .100 and .200 cases per 100 000 population, plus students from sub-Saharan Africa. CONCLUS ION: We found that LTBI screening can be offered effectively in a community college, and could be a complement to primary care-based programmes in low-incidence countries. © 2017 Chipinduro et al.

Author Keywords

Recent migrants LTBI screening tuberculosis Community college

Index Keywords

education Africa south of the Sahara Cost benefit analysis Costs and Cost Analysis mass screening economics cost human Cohort Studies statistics and numerical data interferon gamma release assay Interferon-gamma Release Tests Feasibility Studies procedures screening student Young Adult health care cost migrant Humans Adolescent male England latent tuberculosis female pilot study geographic origin Incidence Article feasibility study adult migration human experiment age Age Factors cohort analysis language class Students community college Transients and Migrants clinical effectiveness Pilot Projects
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85015256288&doi=10.5588%2fijtld.16.0398&partnerID=40&md5=91864adc5f9e7a600bf40d8606e70d98
DOI: 10.5588/ijtld.16.0398
ISSN: 10273719
Cited by: 4
Original Language: English