Prevalence of Tuberculosis Infection in the United States Population

Bennett, Diane; Courval, Jeanne M.; Onorato, Ida M.; Agerton, Tracy B.; Gibson, Judy D.; Lambert, Lauren A.; McQuillan, Geraldine M.; Lewis, Brenda; Navin, Thomas R.; Castro, Kenneth G.

doi:10.1164/rccm.200701-057oc

Cited by 193 publications

(158 citation statements)

References 16 publications

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“…The estimates for LTBI are considerably lower than those reached in our calibration process (25% versus 42% for Brazil and 44% versus 62% for India). The estimate for LTBI in the United States of 7.4% is also higher than the 4.2% LTBI prevalence estimated in [37].…”

Section: Insights From the Calibration Processmentioning

confidence: 55%

“…r < ds). In a recent large-scale study in the United States, it was found that only 25.5% of individuals with LTBI had been diagnosed and that only 13.2% had been prescribed treatment [37]. Treatment for this symptomless condition is lengthy (usually 6-12 months) and often not finished by those who initiate it.…”

Section: How Much Better Would One Vaccination Policy Be?mentioning

confidence: 99%

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Could changes in national tuberculosis vaccination policies be ill-informed ?

Gerberry

Milner

2012

Math. Model. Nat. Phenom.

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Abstract. National policies regarding the BCG vaccine for tuberculosis vary greatly throughout the international community and several countries are currently considering discontinuing universal vaccination. Detractors of BCG point to its uncertain effectiveness and its interference with the detection and treatment of latent tuberculosis infection (LTBI).In order to quantify the trade-off between vaccination and treatment of LTBI, a mathematical model was designed and calibrated to data from Brazil, Ghana, Germany, India, Mexico, Romania, the United Kingdom and the United States. Country-specific thresholds for when LTBI treatment outperforms mass vaccination were found and the consequences of policy changes were estimated.Our results suggest that vaccination outperforms LTBI treatment in all settings but with greatly reduced efficiency in low incidence countries. While national policy statements emphasize BCG's interference with LTBI detection, we find that reinfection should be more determinant of a country's proper policy choice.

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Section: Insights From the Calibration Processmentioning

confidence: 55%

Section: How Much Better Would One Vaccination Policy Be?mentioning

confidence: 99%

Could changes in national tuberculosis vaccination policies be ill-informed ?

Gerberry

Milner

2012

Math. Model. Nat. Phenom.

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“…Applying the methodology used in this study to other populations (11,12) may provide a more complete understanding of the test interpretation and test discordance. Finally, further research is needed to better characterize the most appropriate cutoffs to be used for the risk-stratified interpretation of the IGRAs, to maximize sensitivity and specificity in different risk groups and populations.…”

Section: Discussionmentioning

confidence: 99%

“…A skin test performed with PPD-B is referred to as a "Battey skin test" (BST). The BST has been used as an aid in the differentiation of reactivity to M. tuberculosis from reactivity to NTM in Navy recruit (8,11) and National Health and Nutrition Examination Survey studies (10,12,13). It has also been used in many other smaller epidemiologic studies (14)(15)(16)(17)(18)(19).…”

mentioning

confidence: 99%

Discordance among Commercially Available Diagnostics for Latent Tuberculosis Infection

Mancuso

Mazurek²,

Tribble³

et al. 2012

Am J Respir Crit Care Med

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“…LTBI screening and treatment serve a dual purpose of preventing reactivation of tuberculosis (reactivation TB) in the individual and protecting public health by preventing the spread of TB in the community. Although 9,421 new TB cases were reported in the US in 2014, an estimated 11 million people in the US are living with LTBI [2,3]. The lifetime risk of reactivation TB in those with LTBI is 10 percent, but identification and treatment of LTBI can reduce the risk of active disease by 60-90 percent [4][5][6].…”

mentioning

confidence: 99%

Undocumented Immigrants Face a Unique Set of Risks from Tuberculosis Treatment: Is This Just?

Kyanko

Tsay

Yun

et al. 2016

AMA Journal of Ethics

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Consider a hypothetical scenario: Rosa, a 35-year-old healthy woman, visits a primary care physician at a community clinic for a routine checkup. She immigrated to the United States one year ago from Mexico, a country with a higher prevalence of tuberculosis (27 cases per 100,000 people) [1] than the US [2]. The primary care physician recommends screening for latent tuberculosis infection (LTBI) based on established guidelines. Rosa's purified protein derivative (PPD) skin test is positive, and she is started on isoniazid (isonicotinylhydrazide or INH). While taking it, she develops jaundice and lower extremity edema and is admitted to the hospital. She becomes critically ill and is found to have fulminant hepatic failure-acute liver failure-an iatrogenic consequence of INH treatment. A liver transplant would save her life, but Rosa is deemed not to be a good candidate for transplant because she is poor, uninsured, and undocumented. She dies of liver failure and sepsis. Here we consider the unique risks that undocumented immigrants incur when accepting LTBI therapy and the physician's duty to disclose these risks, and we present policy and clinical solutions that would protect public health without placing undue burden on undocumented immigrants. LTBI screening and treatment serve a dual purpose of preventing reactivation of tuberculosis (reactivation TB) in the individual and protecting public health by preventing the spread of TB in the community. Although 9,421 new TB cases were reported in the US in 2014, an estimated 11 million people in the US are living with LTBI [2,3]. The lifetime risk of reactivation TB in those with LTBI is 10 percent, but identification and treatment of LTBI can reduce the risk of active disease by 60-90 percent [4][5][6].LTBI screening and treatment are particularly important for immigrants from regions where TB is common. Over half (66 percent) of US LTBI cases occur in people born outside the US, and the case rate of reactivation TB among that group is about 13 times higher than among persons born in the US [2]. The Centers for Disease Control and Prevention (CDC) recommend LTBI screening for all immigrants from high-prevalence countries who have lived in the US for less than five years [7]. There were approximately 7 million new immigrants in the US in 2010, including approximately 2.7 million from three high-prevalence countries: Mexico, China, and India [8]. This population also includes 1.8-2.3 million undocumented immigrants [9,10]; these are immigrants who

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Prevalence of Tuberculosis Infection in the United States Population

Abstract: In addition to basic TB control measures, elimination strategies should include targeted evaluation and treatment of individuals in high-prevalence groups, as well as enhanced support for global TB prevention and control.

Cited by 193 publications

References 16 publications

Could changes in national tuberculosis vaccination policies be ill-informed ?

Could changes in national tuberculosis vaccination policies be ill-informed ?

Discordance among Commercially Available Diagnostics for Latent Tuberculosis Infection

Undocumented Immigrants Face a Unique Set of Risks from Tuberculosis Treatment: Is This Just?

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