Detect to Prevent: Evaluating Testing and Treatment Practices for Latent Tuberculosis Infection in Long‐Term Care Facilities

Winston, Carla A.; Stone, Nimalie D.

doi:10.1111/jgs.14752

Cited by 1 publication

(1 citation statement)

References 11 publications

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“…Several papers point out that co-morbidities that are prevalent in aging populations may further increase the risk of developing active TB disease, including diabetes mellitus and chronic obstructive pulmonary disease (COPD) (4,14,15). Canadian data show that ∼25% of residents in LTCF have type 2 diabetes and that the number of residents with type 1 diabetes is unknown X-Ray Screening for TB in Long-Term Facilities It required 1410 screenings with the LTBI approach to avert one active case, at a cost of $10,9913 CAD; it took 1266 screenings with the CXR approach to avert one active case, at a cost of $67,2298 CAD.…”

Section: Specific Considerations On the Risk Of Tb For Elderly Women And Menmentioning

confidence: 99%

Review of Evidence for Using Chest X-Rays for Active Tuberculosis Screening in Long-Term Care in Canada

Herrera

Haworth‐Brockman

Keynan

2020

Front. Public Health

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Background: People living in long-term care facilities (LTCF) are at high risk to develop active tuberculosis primarily as a result of reactivation of a latent TB infection, or endemic transmission between residents. Current national guidelines in Canada are to use a posterior-anterior and lateral chest X-ray to screen for TB for those over 65 years old, upon admission to a LTCF.Objective: To assess the available evidence for cost benefits of universal chest X-ray screening for new LTCF residents.Methodology: We conducted a search for all articles published until September 2018, in PubMed and WorlCat databases, in English, using a combination of key words: chest X-ray, chest radiography or CXR, long-term care, elderly, screening, and tuberculosis. We also reviewed publicly available guidelines for screening new residents to LTCF from across Canada. We report on a qualitative synthesis of the evidence in the documents retrieved.Results: The final review yielded four cost-effectiveness studies (2 of 4 conducted in countries with low incidence), one systematic review, one recommendation/editorial, and one cohort study. We found that in a tuberculosis low-incidence country the CXR cost per identified case was $672,298 CAD. Enacting a more targeted screening program, perhaps one that tests only those who previously had TB, or other high-risk medical conditions may enhance the cost-effectiveness.Recommendations: We suggest reviewing the screening policy for active TB in people entering LTCF, which is based on a CXR. The results indicate that a targeted search for active TB in people with symptoms or other high-risk medical conditions may be more cost-effective.

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Section: Specific Considerations On the Risk Of Tb For Elderly Women And Menmentioning

confidence: 99%

Review of Evidence for Using Chest X-Rays for Active Tuberculosis Screening in Long-Term Care in Canada

Herrera

Haworth‐Brockman

Keynan

2020

Front. Public Health

View full text Add to dashboard Cite

show abstract

Detect to Prevent: Evaluating Testing and Treatment Practices for Latent Tuberculosis Infection in Long‐Term Care Facilities

Cited by 1 publication

References 11 publications

Review of Evidence for Using Chest X-Rays for Active Tuberculosis Screening in Long-Term Care in Canada

Review of Evidence for Using Chest X-Rays for Active Tuberculosis Screening in Long-Term Care in Canada

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