Screening for tuberculosis among high-risk groups attending London emergency departments: a prospective observational study

Rishi K Gupta, Swaib A Lule, Maria Krutikov, Lara Gosce, Nathan Green, Jo Southern, Ambreen Imran, Robert W Aldridge, Heinke Kunst, Marc Lipman, William Lynn, Helen Burgess, Asif Rahman, Dee Menezes, Ananna Rahman, Simon Tiberi, Peter J White, Ibrahim Abubakar, Rishi K Gupta, Swaib A Lule, Maria Krutikov, Lara Gosce, Nathan Green, Jo Southern, Ambreen Imran, Robert W Aldridge, Heinke Kunst, Marc Lipman, William Lynn, Helen Burgess, Asif Rahman, Dee Menezes, Ananna Rahman, Simon Tiberi, Peter J White, Ibrahim Abubakar

Abstract

LTBI screening among high-risk groups at EDs could be implemented to identify those at risk of progression to TB disease. Large-scale studies are required to investigate effective TB disease screening strategies in EDs. https://bit.ly/3bTkoOn

Trial registration: ClinicalTrials.gov NCT02512484.

Conflict of interest statement

Conflict of interest: R.K. Gupta has nothing to disclose. Conflict of Interest: S.A. Lule has nothing to disclose. Conflict of Interest: M. Krutikov has nothing to disclose. Conflict of Interest: L. Gosce has nothing to disclose. Conflict of Interest: N. Green has nothing to disclose. Conflict of Interest: J. Southern has nothing to disclose. Conflict of Interest: A. Imran has nothing to disclose. Conflict of Interest: R.W. Aldridge has nothing to disclose. Conflict of Interest: H. Kunst has nothing to disclose. Conflict of Interest: M. Lipman has nothing to disclose. Conflict of Interest: W. Lynn has nothing to disclose. Conflict of Interest: H. Burgess has nothing to disclose. Conflict of Interest: A. Rahman has nothing to disclose. Conflict of Interest: D. Menezes has nothing to disclose. Conflict of Interest: A. Rahman has nothing to disclose. Conflict of Interest: S. Tiberi has nothing to disclose. Conflict of Interest: P.J. White reports grants from Medical Research Council and National Institute for Health Research, during the conduct of the study; grants from National Institute for Health Research, outside the submitted work. Conflict of Interest: I. Abubakar reports grants from UK Department of Health, during the conduct of the study.

References

    1. The National Institute for Health and Care Excellence . NICE Guidance and Guidelines: Tuberculosis. London, NICE, 2016.
    1. Public Health England . Collaborative Tuberculosis Strategy for England. London, Public Health England, 2015.
    1. Aldridge RW, Zenner D, White PJ, et al. . Tuberculosis in migrants moving from high-incidence to low-incidence countries: a population-based cohort study of 519 955 migrants screened before entry to England, Wales, and Northern Ireland. Lancet 2016; 388: 2510–2518. doi:10.1016/S0140-6736(16)31008-X
    1. Appleton SC, Connell DW, Singanayagam A, et al. . Evaluation of prediagnosis emergency department presentations in patients with active tuberculosis: the role of chest radiography, risk factors and symptoms. BMJ Open Respir Res 2017; 4: e000154.
    1. World Health Organization . Using the Xpert MTB/RIF assay to detect pulmonary and extrapulmonary tuberculosis and rifampicin resistance in adults and children. Expert group meeting report. Geneva, World Health Organization, 2013.
    1. Aldridge RW, Shaji K, Hayward AC, et al. . Accuracy of probabilistic linkage using the enhanced matching system for public health and epidemiological studies. PLoS One 2015; 10: e0136179. doi:10.1371/journal.pone.0136179
    1. University College London . Improving the Detection of Active Tuberculosis in Accident and Emergency Departments. Date last updated: 26 Feb 2016. Date last accessed: 5 Dec 2020.
    1. Geyer BC, Godwin P, Powell TJ, et al. . Patient factors associated with failure to diagnose tuberculosis in the emergency department. J Emerg Med 2013; 45: 658–665. doi:10.1016/j.jemermed.2013.05.002
    1. Sokolove PE, Rossman L, Cohen SH. The emergency department presentation of patients with active pulmonary tuberculosis. Acad Emerg Med 2000; 7: 1056–1060. doi:10.1111/j.1553-2712.2000.tb02100.x
    1. Lad TS, Packe GE. Tuberculosis: a missed opportunity for early diagnosis at the front line? Emerg Med J 2014; 31: 942–943. doi:10.1136/emermed-2013-202442
    1. Smith A, Miller RF, Story A, et al. . A&E department: a missed opportunity for diagnosis of TB? Thorax 2006; 61: 364–365. doi:10.1136/thx.2005.053637
    1. Silva DR, Müller AM, Tomasini KS, et al. . Active case finding of tuberculosis (TB) in an emergency room in a region with high prevalence of TB in Brazil. PLoS One 2014; 9: e107576. doi:10.1371/journal.pone.0107576
    1. Ticona E, Huaman MA, Huaroto LM, et al. . Tuberculosis screening using ability to provide sputum in an endemic emergency department. Eur Respir J 2016; 47: 330–333. doi:10.1183/13993003.00877-2015
    1. Kirsch TD, Chanmugam A, Keyl P, et al. . Feasibility of an emergency department-based tuberculosis counseling and screening program. Acad Emerg Med 1999; 6: 224–231. doi:10.1111/j.1553-2712.1999.tb00161.x
    1. Gupta RK, Kunst H, Lipman M, et al. . Evaluation of QuantiFERON-TB gold plus for predicting incident tuberculosis among recent contacts: a prospective cohort study. Ann Am Thorac Soc 2020; 17: 646–650. doi:10.1513/AnnalsATS.201905-407RL
    1. Abubakar I, Drobniewski F, Southern J, et al. . Prognostic value of interferon-gamma release assays and tuberculin skin test in predicting the development of active tuberculosis (UK PREDICT TB): a prospective cohort study. Lancet Infect Dis 2018; 18: 1077–1087. doi:10.1016/S1473-3099(18)30355-4

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する