TY - JOUR
T1 - Emergency department screening for latent tuberculosis infection
AU - Faryar, Kiran A.
AU - Braun, Robert
AU - Ancona, Rachel M.
AU - Ajayi, Eloho
AU - Bryant, Whitney
AU - Rehman, Swairah
AU - Sall, Hawa
AU - Lyons, Michael S.
AU - Huaman, Moises A.
N1 - Funding Information:
This work was supported by the University of Cincinnati Latino Faculty Association (UC LFA) Small Grants Award , awarded to MAH. The authors thank all Early Intervention Program (EIP) health promotion advocates (HPAs) and linkage coordinators for their tireless efforts. We also thank all patients and clients who participated in our screening program for their participation.
Funding Information:
This work was supported by the University of Cincinnati Latino Faculty Association (LFA) Small Grants Award , University of Cincinnati College of Medicine, USA.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/4
Y1 - 2022/4
N2 - Objective: Approximately 12.4 million people in the U.S. have latent tuberculosis infection (LTBI), 73% of whom are non-U.S. born. Identification and treatment of LTBI are essential for tuberculosis eradication. We evaluated an emergency department (ED) – based LTBI screening and linkage to care program. Methods: We queried electronic records of a clinical prevention program located in a Midwestern, urban, academic ED that serves as the region's safety-net hospital. Program staff approached non-U.S. born ED patients from TB endemic areas. Patients received QuantiFERON-TB Gold Plus (QFT) blood testing and, if positive, were referred to treatment. The primary outcome was the proportion of tested patients newly diagnosed with LTBI. We secondarily report the number of patients linked to care who initiated LTBI treatment. Results: The program approached 33 patients, of whom 24 (72.7%) were eligible, and 23 (95.8%) were tested. The majority were male (13, 56.5%), median age was 33 years (IQR 27–45), and 13 (56.5%) were from Latin America. Three patients (13.0%, 95% CI 0.03–0.35) were newly diagnosed with LTBI and linked to care; two (66.7%) started LTBI treatment. Conclusions: In this first report of an ED-based LTBI screening program implemented in a region with low TB prevalence, over 10% of high-risk ED patients tested positive for LTBI and were linked to treatment. Screening populations at risk for LTBI in EDs and linking them to public health treatment services should be prioritized in order to achieve TB elimination in the U.S.
AB - Objective: Approximately 12.4 million people in the U.S. have latent tuberculosis infection (LTBI), 73% of whom are non-U.S. born. Identification and treatment of LTBI are essential for tuberculosis eradication. We evaluated an emergency department (ED) – based LTBI screening and linkage to care program. Methods: We queried electronic records of a clinical prevention program located in a Midwestern, urban, academic ED that serves as the region's safety-net hospital. Program staff approached non-U.S. born ED patients from TB endemic areas. Patients received QuantiFERON-TB Gold Plus (QFT) blood testing and, if positive, were referred to treatment. The primary outcome was the proportion of tested patients newly diagnosed with LTBI. We secondarily report the number of patients linked to care who initiated LTBI treatment. Results: The program approached 33 patients, of whom 24 (72.7%) were eligible, and 23 (95.8%) were tested. The majority were male (13, 56.5%), median age was 33 years (IQR 27–45), and 13 (56.5%) were from Latin America. Three patients (13.0%, 95% CI 0.03–0.35) were newly diagnosed with LTBI and linked to care; two (66.7%) started LTBI treatment. Conclusions: In this first report of an ED-based LTBI screening program implemented in a region with low TB prevalence, over 10% of high-risk ED patients tested positive for LTBI and were linked to treatment. Screening populations at risk for LTBI in EDs and linking them to public health treatment services should be prioritized in order to achieve TB elimination in the U.S.
KW - Emergency department
KW - Latent tuberculosis infection
KW - Non-US born
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=85119117507&partnerID=8YFLogxK
U2 - 10.1016/j.ajem.2021.09.076
DO - 10.1016/j.ajem.2021.09.076
M3 - Article
C2 - 34756647
AN - SCOPUS:85119117507
SN - 0735-6757
VL - 54
SP - 323.e5-323.e8
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
ER -