Expected background rates of latent TB infection in London inner city schools: lessons from a TB contact investigation exercise in a secondary school.

Abstract:

:Following an extensive contact tracing exercise at a school in a London borough with one of highest tuberculosis (TB) rates in England, we estimated the background prevalence of latent TB infection to be significantly less than the widely accepted 10%. We screened 271 pupils aged 14-15 years in two groups: 96 pupils in group 1 had significant exposure (>8 h/week in the same room) to a case of infectious TB and 175 in group 2 who had minimal exposure. In group 1, 26% were diagnosed with latent or active TB, compared to 6.3% in group 2. Risk factors for TB infection (e.g. previous exposure or link to high-prevalence communities) were analysed using a cohort study design. In the univariable analysis only being in contact group 1 was statistically significantly associated with being a case (OR 5.25, 95%, P < 0.001). In the multivariable model contact group 1 remained significantly associated with being a case (adjusted OR 4.40, P = 0.001). We concluded that the 6.3% yield of TB infection in contact group 2 is either similar to or higher than the background prevalence rate of latent TB infection (LTBI) in this high TB prevalence London borough. Other parts of England with lower TB prevalence are likely to have even lower LTBI rates.

journal_name

Epidemiol Infect

authors

Anaraki S,Bell AJ,Perkins S,Murphy S,Dart S,Anderson C

doi

10.1017/S0950268818002327

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

2102-2106

issue

16

eissn

0950-2688

issn

1469-4409

pii

S0950268818002327

journal_volume

146

pub_type

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