Lessons Learned from Implementation of an Interferon Gamma Release Assay to Screen for Latent Tuberculosis Infection in a Large Multicenter Observational Cohort Study in Brazil

Abstract

Methods: Contacts of 1,672 TB patients were retrospectively studied between 2009 and 2014. Data on TB screening by clinical investigation, radiographic examination, and tuberculin skin test (TST) were extracted from medical records. Losses in the cascade of care and TB incidence within a 2-year follow-up were calculated.

Results: From a total of 1,180 TB contacts initially identified, only 495 were examined (58% loss), and 20 were diagnosed with active TB at this stage. Furthermore, 435 persons returned for TST result interpretation and 351 (~81%) were TST positive. Among those with positive TST, 249 (73%) were treated with isoniazid for 6 months whereas 51 abandoned therapy early. A logistic regression analysis revealed that increases in age were associated with losses in the LTBI cascade independent of other clinical and epidemiological characteristics.

Conclusions: Major losses occur at initial stages and older patients are at higher risk of not completing the LTBI cascade of care.

Keywords: Tuberculosis; Latent TB infection; LTBI cascade; Treatment for latent TB.

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• Data de Publicação: 11/02/2020
• Autores: Nélia C.N. Araújoa,b,c,d,1 , Constança M.S. Cruza,e,1 , María B. Arriagac,f,1 , Juan M. Cubillos-Anguloc,f,1 , Michael S. Rochab,c , Paulo S. Silveira-Mattosc,f,g , Gisela M. Matosa , Izabella M.B. Marquesa , Isa Carolina P. Espirito Santoa , Luiza L. Almeidaa , Caroline M. Andradea , Leonardo A. Souzaa , Eduardo M. Nettob,d , Bruno B. Andradea,c,f,g,h,