Identifying components for programmatic latent tuberculosis infection control in the European Union

Abstract

Individuals with latent tuberculosis infection (LTBI) are the reservoir of Mycobacterium tuberculosis in a population and as long as this reservoir exists, elimination of tuberculosis (TB) will not be feasible. In 2013, the European Centre for Disease Prevention and Control (ECDC) started an assessment of benefits and risks of introducing programmatic LTBI control, with the aim of providing guidance on how to incorporate LTBI control into national TB strategies in European Union/European Economic Area (EU/EEA) Member States and candidate countries. In a first step, experts from the Member States, candidate countries, and international and national organisations were consulted on the components of programmatic LTBI control that should be considered and evaluated in literature reviews, mathematical models and cost-effectiveness studies. This was done through a questionnaire and two interactive discussion rounds. The main components identified were identification and targeting of risk groups, determinants of LTBI and progression to active TB, optimal diagnostic tests for LTBI, effective preventive treatment regimens, and to explore the potential for combining LTBI control with other health programmes. Political commitment, a solid healthcare infrastructure, and favourable economic situation in specific countries were identified as essential to facilitate the implementation of programmatic LTBI control.

Implementation of latent tuberculosis infection screening and treatment among newly arriving immigrants in the Netherlands: A mixed methods pilot evaluation

“…It is therefore important to create more awareness and knowledge about TB and LTBI among both clients and healthcare workers in the home countries. [28]…”

Barriers to treatment adherence for individuals with latent tuberculosis infection: A systematic search and narrative synthesis of the literature

“…Thus, there is a need to prioritize the management of LTBI to meet the goal of TB elimination . This is reflected in the recent statement by the European Centre for Disease Control, which has strongly emphasized the need for greater political commitment to facilitate LTBI control …”

“…62 This is reflected in the recent statement by the European Centre for Disease Control, which has strongly emphasized the need for greater political commitment to facilitate LTBI control. 63 The WHO guidelines for countries with low-TB incidence include a range of different drug regimens and durations for LTBI treatment. In a review conducted for these guidelines, no single regimen was associated with better efficacy for the prevention or reactivation of TB.…”

Evaluation of the latent tuberculosis screening and treatment strategy for asylum seekers in Stockholm, Sweden 2015–2018: a record linkage study of the care cascade

“…[1,2] Consequently, LTBI screening and management for migrants is an important intervention to reduce TB incidence in those countries. [1,3,4] The TB incidence in Sweden is 5/100,000 (2018). [5] Approximately 90% of active TB cases notified in Sweden are among migrants and the vast majority of these cases are deemed to be reactivated from LTBI acquired outside of Sweden.…”