This article is more than 5 years old. Information may no longer be current.
Screening immigrants for TB prevented latent TB, additional active cases
Pareek M. Lancet Infect Dis.2011;doi:10.1016/S1473-3099(11)70069-X.
Click Here to Manage Email Alerts
The prevalence of latent tuberculosis infection varied by gender, age and the country of origin among immigrants in the United Kingdom. Researchers, therefore, suggest screening immigrants for latent tuberculosis infection because it is a cost-effective way to prevent future cases of active tuberculosis, according to Ajit Lalvani, MD, and colleagues.
“UK national guidance for which groups to screen excludes most immigrants with latent infection, and our analysis suggests that policy could be modified in centers undertaking or considering the implementation of one-step interferon-gamma release-assay to substantially reduce TB incidence while remaining cost-effective,” Lalvani, a professor at the Tuberculosis Research Unit of the Imperial College London, and colleagues wrote.
The researchers pooled demographic and test result data on 1,229 UK immigrants, aged 35 years and younger, across three centers in the UK that used interferon-gamma release-assay between 2008 and 2010. Logistic regression analysis was used to assess the cost-effectiveness of screening at different levels of TB incidence in countries of origin.
Data indicated a high prevalence of positive latent TB infection among 20% of immigrants (95% CI, 18-22). Positive screening results were associated with male gender (P=.046), age (P,.0001) and increased TB incidence in countries of origin (P=.0006). Specifically, 32% of immigrants originated from Pakistan and 26% from India.
Screening immigrants from countries with a TB incidence of more than 250 cases per 100,000 and in countries with a more than 150 cases per 100,000 were the two most cost-effective strategies, according to the researchers.
“As national guidelines are developed for screening of latent TB with new techniques (such as [interferon-gamma release-assay]), they will need to quantitatively integrate the prevalence of latent infection in immigrant populations from different regions to formulate policy that cost-effectively improves TB control and prevention,” the researchers wrote.
Disclosure: This research was funded by Medical Research Council and Wellcome Trust.