Effectiveness Of Post-Arrival Latent Tuberculosis Screening Programs In The Foreign Born: A Systematic Review And Meta-Analysis

Bettache, Nazila; Schwartzman, Kevin; Cnossen, Sonya; Sandoe, Amelia; Assayag, Deborah; Menzies, Dick; Greenaway, Christina

doi:10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a3325

Cited by 7 publications

(7 citation statements)

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“…Using a single blood test taken at the same time as routine screening while also addressing other patient health concerns appeared to lower drop-offs in the cascade of care. 99/100 complete test results in eligible individuals, as well as seven of nine eligible individuals starting and completing prophylaxis compares very favourably to rates reported in the literature (Greenaway et al 2013;Bettache et al 2012). IGRA has a greater specificity than TST (tuberculin skin test) in populations with high BCG vaccinations such as Syria, and recent consensus guidelines suggest this is the standard of care in this population (World Health Organization 2016c; Lewinsohn et al 2017).…”

Section: Discussionsupporting

confidence: 60%

Prevalence of latent tuberculosis infection in Syrian refugees to Canada

Warrington

Tyrrell

Choy

et al. 2018

Can J Public Health

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Section: Discussionsupporting

confidence: 60%

Prevalence of latent tuberculosis infection in Syrian refugees to Canada

Warrington

Tyrrell

Choy

et al. 2018

Can J Public Health

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“…A systematic review and meta-analysis of LTBI screening in immigrants arriving into countries of low TB incidence found substantial loss at every step of the cascade of care and ultimately only 32 percent of those found to have LTBI actually completed treatment with prophylaxis [ 24 ]. The low rate of completion was felt to be in part due to a lack of linguistic and cultural support for the immigrants.…”

Section: Discussionmentioning

confidence: 99%

A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic

Rennert-May

Hansen

Zadeh

et al. 2016

Canadian Respiratory Journal

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Objectives. Approximately 65 percent of tuberculosis (TB) cases in Canada each year occur from reactivation in foreign-born individuals. Refugees are at high risk after immigration. Routine screening of this population for latent TB infection (LTBI) is generally considered infeasible. We evaluated the outcome of LTBI screening and treatment amongst refugees. Methods. Government-sponsored refugees in Edmonton are seen at the New Canadians' Clinic and screened for TB and LTBI. We reviewed records of patients between 2009 and 2011. Completeness of initial assessment, diagnosis of latent infection, and completion of LTBI treatment were evaluated. Treatment for LTBI was offered when patients had a positive Tuberculin Skin Test (TST) and risk factors for progression to TB. An Interferon-Gamma Release Assay (IGRA) was performed on all other TST positives; treatment is only offered if it was positive. Results. 949 refugees were evaluated. 746 TSTs were read, with 265 positive individuals. IGRA testing was performed in 203 TST positive individuals without other TB risk factors; 110 were positive. LTBI treatment was offered to 147 of 151 eligible patients, 141 accepted, and 103 completed a treatment course. Conclusion. We observed high proportions of patient retention, completion of investigations, and treatment. This care model promises to be a component of effective TB prevention in this high-risk population.

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“…While TST specificity is influenced by BCG vaccination history and, less commonly, exposure to non-tuberculosis mycobacteria, further disadvantages include variability in interpretation of results and requirement for provider training [80]. Additionally, the requirement of test reading 48-72 h after injection leads to low TST screening completion (69 %; 95 % CI 69-70 %) [81]. In contrast, the IGRA does not require follow-up, but does have significant sources of variability, poor reproducibility and is more expensive to administer.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review on TST and IGRA Tests Used for Diagnosis of LTBI in Immigrants

et al. 2015

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Prevalence of positive test results were significantly lower in immigrants who were tested with an IGRA, resulting in fewer immigrants being recommended for LTBI treatment compared to TST. Coupled with comparable performance for detecting prevalent TB cases, the IGRA appears to exhibit better specificity than the TST and may be preferred as the standard of care for detecting LTBI in immigrants moving to low TB incidence countries.

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Effectiveness Of Post-Arrival Latent Tuberculosis Screening Programs In The Foreign Born: A Systematic Review And Meta-Analysis

Cited by 7 publications

References 0 publications

Prevalence of latent tuberculosis infection in Syrian refugees to Canada

Prevalence of latent tuberculosis infection in Syrian refugees to Canada

A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic

A Systematic Review on TST and IGRA Tests Used for Diagnosis of LTBI in Immigrants

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