Featured Research

from universities, journals, and other organizations

TB Screening Needs To Be Targeted For Maximum Public Health Benefit, Study Suggests

Date:
May 19, 2009
Source:
American Thoracic Society
Summary:
New estimates of the likelihood that a latent case of tuberculosis will become active have resulted in a roughly 50 percent increase over previous estimates of the number of people needed to be screened to prevent an active infection, limiting the cost effectiveness of screening in many Center for Disease Control and Prevention-defined risk groups, according to an analysis conducted by experts in the epidemiology of the disease.

New estimates of the likelihood that a latent case of tuberculosis (TB) will become active have resulted in a roughly 50 percent increase over previous estimates of the number of people needed to be screened (NNS) to prevent an active infection, limiting the cost effectiveness of screening in many Center for Disease Control and Prevention (CDC)-defined risk groups, according to an analysis conducted by experts in the epidemiology of the disease.

The research was presented at the American Thoracic Society's 105th International Conference on Tuesday, May 19.

"Screening for LTBI [latent tuberculosis infection] is an important method for eliminating the diseases," says lead researcher Benjamin Linas, M.D., M.P.H., of Massachusetts General Hospital. "This analysis, does not suggest we reduce screening. Indeed, if we did that, we'd likely take a step backward in TB control. The study does suggest, though, that we redirect and focus our screening efforts on those most at risk."

Among patients with chronic medical conditions, the NNS to prevent an active case of TB ranged from 1,150 for those who are underweight to 2,778 for patients with end-stage renal disease. Previous estimates of the NNS ranged from 806 to 1,923. Screening was not cost-effective for many patients who are currently recommended for screening, including those who are underweight, have had a gastrectomy, or have silicosis, diabetes or end stage renal disease. Screening was a cost-effective strategy under previous estimates of the rate of reactivation TB, but the new, lower estimates of reactivation limited the case finding rate and decreased the cost effectiveness of screening.

The NNS was lower in populations with a high prevalence of latent TB infection, including foreign-born residents, recent immigrants, the homeless and injection drug users. It was also lower in patients with a high risk of reactivation TB, including those with HIV infection and those taking immunosuppressive medications. As a result, screening remained cost effective for these groups.

Dr. Linas and his colleagues, from MGH and Boston University School of Public Health, based their analysis on several new estimates of TB reactivation rates gathered from 1998-2005. According to Dr. Linas, current guidelines for screening are based on rates indicated from studies conducted in the 1950s and 1960s.

To arrive at new estimates of NNS and cost effectiveness, the Boston-based researchers constructed a Markov computer model that simulates the clinical progression of a cohort of patients, can integrate a wide array of parameters and allows the analysts to plug in different estimates to determine which are most important in determining outcomes.

In addition to the old and new estimates of reactivation rates, the group included in their model estimates based on published reports of TB mortality, percent of diagnosed patients who complete isoniazid (INH), the standard therapy for LTBI (for U.S.-born residents, 50 percent; for foreign-born, 48 percent) and the effectiveness of the therapy among those who complete it.

"The take home message of this research," Dr. Linas said, "is not that we should reduce funding for LTBI screening, but that we can use current funding to make greater strides toward eliminating TB by targeting those at highest risk for latent infection becoming active."


Story Source:

The above story is based on materials provided by American Thoracic Society. Note: Materials may be edited for content and length.


Cite This Page:

American Thoracic Society. "TB Screening Needs To Be Targeted For Maximum Public Health Benefit, Study Suggests." ScienceDaily. ScienceDaily, 19 May 2009. <www.sciencedaily.com/releases/2009/05/090519172047.htm>.
American Thoracic Society. (2009, May 19). TB Screening Needs To Be Targeted For Maximum Public Health Benefit, Study Suggests. ScienceDaily. Retrieved October 22, 2014 from www.sciencedaily.com/releases/2009/05/090519172047.htm
American Thoracic Society. "TB Screening Needs To Be Targeted For Maximum Public Health Benefit, Study Suggests." ScienceDaily. www.sciencedaily.com/releases/2009/05/090519172047.htm (accessed October 22, 2014).

Share This



More Science & Society News

Wednesday, October 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Chameleon Camouflage to Give Tanks Cloaking Capabilities

Chameleon Camouflage to Give Tanks Cloaking Capabilities

Reuters - Innovations Video Online (Oct. 22, 2014) Inspired by the way a chameleon changes its colour to disguise itself; scientists in Poland want to replace traditional camouflage paint with thousands of electrochromic plates that will continuously change colour to blend with its surroundings. The first PL-01 concept tank prototype will be tested within a few years, with scientists predicting that a similar technology could even be woven into the fabric of a soldiers' clothing making them virtually invisible to the naked eye. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Jet Sales Lift Boeing Profit 18 Pct.

Jet Sales Lift Boeing Profit 18 Pct.

Reuters - Business Video Online (Oct. 22, 2014) Strong jet demand has pushed Boeing to raise its profit forecast for the third time, but analysts were disappointed by its small cash flow. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

Newsy (Oct. 22, 2014) Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
Powered by NewsLook.com
US to Track Everyone Coming from Ebola Nations

US to Track Everyone Coming from Ebola Nations

AP (Oct. 22, 2014) Stepping up their vigilance against Ebola, federal authorities said Wednesday that everyone traveling into the US from Ebola-stricken nations will be monitored for symptoms for 21 days. (Oct. 22) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Science & Society

Business & Industry

Education & Learning

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins