Implementation of latent tuberculosis screening in HIV care centres: evaluation in a low tuberculosis incidence setting.
Epidemiol Infect
; 144(4): 703-11, 2016 Mar.
Article
en En
| MEDLINE
| ID: mdl-26211466
The screening and treatment of latent tuberculosis infection (LTBI) to prevent active tuberculosis (TB) is recommended by the WHO in all HIV-infected patients. The aim of this study was to evaluate its implementation within Belgium's HIV care. A multiple-choice questionnaire was sent to 55 physicians working in the country's AIDS reference centres. Response rate reached 62%. Only 20% screened all their HIV-infected patients for LTBI. Screening methods used and their interpretation vary from one physician to another. The main barriers to the implementation of LTBI screening and treatment, as perceived by the participants, are lack of sensitivity of screening tools, risks associated with polypharmacy and toxicity of treatment. The poor coverage of LTBI screening reported here and the inconsistency in methods used raises concern. However, this was not unexpected as, in low-TB incidence countries, who, when and how to screen for LTBI remains unclear and published guidelines show important disparities. Recently, a targeted approach in which only HIV-infected patients at highest risk of TB are screened has been suggested. Such a strategy would limit unnecessary exposure to LTBI treatment. This methodology was approved by 80% of the participants and could therefore achieve greater coverage. Its clinical validation is still pending.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tamizaje Masivo
/
Tuberculosis Latente
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Incidence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
/
Screening_studies
País/Región como asunto:
Europa
Idioma:
En
Revista:
Epidemiol Infect
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
/
EPIDEMIOLOGIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Bélgica
Pais de publicación:
Reino Unido