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Diagnosis and management of tuberculosis infection in inclusion health populations in London.
Gray, Adam; Surey, Julian; Veitch, Martha; Menezes, Dee; Gibbons, John; Leonard, Mark; Sultan, Binta; Esmail, Hanif; Story, Al.
Afiliación
  • Gray A; University College London Hospitals, London, UK.
  • Surey J; Hospital for Tropical Diseases, University College London Hospitals, London, UK.
  • Veitch M; Institute for Global Health, University College London, London, UK.
  • Menezes D; University College London Hospitals, London, UK.
  • Gibbons J; Institute for Global Health, University College London, London, UK.
  • Leonard M; Universidad Autonoma de Madrid, Madrid, Spain.
  • Sultan B; University College London Hospitals, London, UK.
  • Esmail H; Public Health Data Science, Institute of Health Informatics, University College London, London, UK.
  • Story A; University College London Hospitals, London, UK.
BMC Infect Dis ; 24(1): 252, 2024 Feb 23.
Article en En | MEDLINE | ID: mdl-38395793
ABSTRACT

BACKGROUND:

Tuberculosis in the UK is more prevalent in people with social risk factors- e.g. previous incarceration, homelessness - and in migrants from TB endemic countries. The management of TB infection is part of TB elimination strategies, but is challenging to provide to socially excluded groups and the evidence base for effective interventions is small.

METHODS:

We evaluated a TB infection screening and treatment programme provided by a peer-led service (Find&Treat) working in inclusion health settings (e.g. homeless hostels) in London. IGRA (interferon-gamma release assay) testing and TB infection treatment were offered to eligible adults using a community-based model. The primary outcome was successful progression through the cascade of care. We also evaluated socio-demographic characteristics associated with a positive IGRA.

RESULTS:

42/312 (13.5%) participants had a positive IGRA and no one had evidence of active TB. 35/42 completed a medical evaluation; 22 started treatment, and 17 completed treatment. Having a positive IGRA was associated with previous incarceration and being born outside of the UK.

DISCUSSION:

Provision of TB infection diagnosis and management to this socially excluded population has several challenges including maintaining people in care and drug-drug interactions. Peer-support workers provided this service safely and effectively with appropriate support. Further work to generate data to inform risks and benefits of treatment for TB infection in this group is needed to facilitate joint decision making.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Tuberculosis Latente Límite: Adult / Humans País/Región como asunto: Europa Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Tuberculosis Latente Límite: Adult / Humans País/Región como asunto: Europa Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido