Toggle Main Menu Toggle Search

Open Access padlockePrints

Evaluating UK national guidance for screening of children for tuberculosis a prospective multicenter study

Lookup NU author(s): Dr Zohreh Nademi

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Abstract

Copyright 2018 by the American Thoracic Society. Rationale: To identify infected contacts of tuberculosis (TB) cases, the UK National Institute for Health and Care Excellence (NICE) recommended the addition of IFN-g release assays (IGRA) to the tuberculin skin test (TST) in its 2006 TB guidelines. Treatment for TB infection was no longer recommended for children who screened TST-positive but IGRA-negative. Objectives: We performed a cohort study to evaluate the risk of TB disease in this group. Methods: Children exposed to an infectious case of TB in their household were recruited from 11 pediatric TB clinics. TST and IGRA were performed at baseline, with IGRA repeated at 8 weeks and TST repeated if initially negative. Children were treated according to 2006 NICE guidelines and followed for 24 months. Measurements and Main Results: Of 431 recruited children, 392 completed the study. We diagnosed 48 (12.2%) cases of prevalent TB disease, 105 (26.8%) with TB infection, and 239 (60.9%) without TB infection or disease. Eighteen children aged 2 years and above had a positive TST but persistently negative IGRA. None received TB infection treatment and none developed TB disease. Ninety (26.1%) children qualified for TB infection treatment according to 2006 NICE guidelines. In contrast, 147 (42.7%) children would have qualified under revised NICE guidance, issued in 2016. Conclusions: In this low-prevalence setting we saw no incident cases of TB disease in children who were TST-positive but IGRA-negative and did not receive treatment for TB infection. Following the latest NICE guidance, significantly more children will require medication.


Publication metadata

Author(s): Kampmann B, Seddon JA, Paton J, Nademi Z, Keane D, Williams B, Williams A, Liebeschutz S, Riddell A, Bernatoniene J, Patel S, Martinez N, McMaster P, Basu-Roy R, Welch SB

Publication type: Article

Publication status: Published

Journal: American Journal of Respiratory and Critical Care Medicine

Year: 2018

Volume: 197

Issue: 8

Pages: 1058-1064

Print publication date: 15/04/2018

Acceptance date: 30/11/2017

ISSN (print): 1073-449X

ISSN (electronic): 1535-4970

Publisher: American Thoracic Society

URL: https://doi.org/10.1164/rccm.201707-1487OC

DOI: 10.1164/rccm.201707-1487OC


Altmetrics

Altmetrics provided by Altmetric


Actions

Find at Newcastle University icon    Link to this publication


Share