Screening for TB by sputum culture in high-risk groups in Copenhagen, Denmark: a novel and promising approach

Abstract

Screening for TB by spot sputum culture is possible and a promising alternative to mobile X-ray in a community based screening programme. 22.2% did not have chest X-ray suggestive of TB and would not have been identified using mobile X-ray. Most of the TB cases were smear-negative, suggesting that they were identified at an early, less infectious stage, which is essential in order to prevent transmission and gain infection control.

Epidemiology of tuberculous lymphadenitis in Denmark: A nationwide register-based study

“…Among Danish-born TB patients in general, TB has often been associated with specific risk factors, e.g. social marginalization or reactivation of LTBI due to increasing age [27,28]. The higher five-year mortality seen among Danes in our study could partly be explained by a higher median age, but probably also reflects that TB in Danes more often is seen in vulnerable and hard-to-reach groups such as homeless or drug abusers [27].…”

“…social marginalization or reactivation of LTBI due to increasing age [27,28]. The higher five-year mortality seen among Danes in our study could partly be explained by a higher median age, but probably also reflects that TB in Danes more often is seen in vulnerable and hard-to-reach groups such as homeless or drug abusers [27]. For the immigrant TBLA patients, a more recent and intensive exposure in the their country of origin most likely explains their younger age [28] but also reflects that individuals migrating are often young or middle-aged [29], as migration may be physically demanding.…”

Preliminary Feasibility Study of Questionnaire-based Active Pulmonary Tuberculosis Screening in Marseille Sheltered Homeless People, Winter 2018

“…Restricting the screening to individuals with symptoms of active TB is more effective in lowering TB importation and less expensive [2]. As a gold standard for the diagnosis of active pulmonary TB [3], sputum culture for TB has been recommended as a screening tool in a systematic and community-based screening program for TB in high-risk groups in low-incidence countries [4,5], but it is expensive and time-consuming. In France, active screening for TB by chest radiography [Chest X-rays (CXR)] is recommended in migrants who have arrived <2 years ago from countries with high TB endemicity [6].…”

Trends and differences in tuberculosis incidences and clustering among natives in Denmark, Sweden and Finland: comparison of native incidences and molecular epidemiology among three low-incidence countries

“…Differences in social challenges among the countries as well as differences in the organization and funding of TB control are two other possible causes for the observed results. In a recent study sputum culture screening for TB was performed at 11 locations in Copenhagen where socially marginalized people gather, and 36 cases of TB were identified among 1075 participants [15]. This large number identified by screening a high-risk group suggests that pockets of hot spots sustain TB transmission in Copenhagen.…”