Yield of testing and treatment for tuberculosis among foreign-born persons during contact investigations in the United States: A semi-systematic review - PubMed (original) (raw)

Review

Yield of testing and treatment for tuberculosis among foreign-born persons during contact investigations in the United States: A semi-systematic review

Andrea Parriott et al. PLoS One. 2018.

Abstract

Background: Contact investigation is an important strategy for maintaining control of tuberculosis (TB) in the United States. However, testing and treatment outcomes specifically to foreign-born populations are poorly understood. We reviewed literature on testing and LTBI identified during contact investigations in foreign-born populations living in the US.

Methods: We conducted a comprehensive search of peer-reviewed and grey literature using Cochrane systematic review methods. We included studies with adult and adolescent populations that were at least 50% foreign-born. Pooled proportions and 95% confidence intervals (CIs) were calculated via inverse-variance weighted meta-analysis, and cumulative proportions were calculated as products of adjacent step proportions.

Results: We identified 22 studies published between 1997 and 2014 that included at least 50% foreign-born participants. From studies of predominantly (>90%) foreign-born populations, almost all identified contacts were recruited and had valid test results, and 54.8% (95% CI 45.1-62.5%) of contacts with valid test results tested positive. From studies of majority (50% to 90%) foreign-born populations, 78.4% (95% CI 78.0-78.9%) of identified contacts were recruited, 92.0% (95% CI 91.6-92.3%) of recruited contacts had valid test results, and 38.5% (95% CI 31.9%-44.2%) of persons with valid results tested positive. These proportions varied by test type in studies of predominantly foreign-born populations. For every 1000 contacts identified in predominantly foreign-born populations, we estimate that 535 (95% CI 438 to 625) will test positive, and 354 (95% CI 244 to 453) will complete LTBI treatment. For every 1000 contacts identified in majority foreign-born populations, these estimates are 276 (95% CI 230 to 318), and 134 (95% CI 44 to 264), respectively.

Conclusions: Contact investigation is a high yield activity for identifying and treating foreign-born persons with LTBI, but must be complemented by other tuberculosis control activities in order to achieve continued progress toward TB elimination.

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Conflict of interest statement

The authors have declared that no competing interests exist. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC or other authors’ affiliated institutions.

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References

    1. Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 2015. Atlanta, GA: Services United States Department of Health and Human Services; 2016.
    1. Miramontes R, Hill AN, Yelk Woodruff RS, Lambert LA, Navin TR, Castro KG, et al. Tuberculosis Infection in the United States: Prevalence Estimates from the National Health and Nutrition Examination Survey, 2011–2012. PloS one. 2015;10(11):e0140881 10.1371/journal.pone.0140881 ; PubMed Central PMCID: PMC4633161. -DOI -PMC -PubMed
    1. Davidow AL, Katz D, Ghosh S, Blumberg H, Tamhane A, Sevilla A, et al. Preventing Infectious Pulmonary Tuberculosis Among Foreign-Born Residents of the United States. Am J Public Health. 2015;105(9):e81–8. 10.2105/AJPH.2015.302662 ; PubMed Central PMCID: PMC4539796. -DOI -PMC -PubMed
    1. Liu Y, Painter JA, Posey DL, Cain KP, Weinberg MS, Maloney SA, et al. Estimating the impact of newly arrived foreign-born persons on tuberculosis in the United States. PloS one. 2012;7(2):e32158 10.1371/journal.pone.0032158 ; PubMed Central PMCID: PMC3287989. -DOI -PMC -PubMed
    1. Mazurek GH, Jereb J, Vernon A, LoBue P, Goldberg S, Castro K, et al. Updated guidelines for using Interferon Gamma Release Assays to detect Mycobacterium tuberculosis infection—United States, 2010. MMWR Recommendations and reports: MMWR Recomm Rep. 2010;59(RR-5):1–25. . -PubMed

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