A cohort study of the long-term outcome of latent tuberculosis infection among socially marginalized people in a low-incidence country

Nina Breinholt Stærke*, Janne Tegder Martinsen, Torben Tranborg Jensen, Ulla Møller Weinreich, Ole Hilberg, Dorte Bek Folkvardsen, Christian Wejse, Andreas Fløe

*Corresponding author for this work

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Abstract

Background: Tuberculosis (TB) prevalence is high among socially marginalized citizens in Denmark, and management of latent TB infection (LTBI) may be part of preventing new cases. Patients with LTBI are offered either preventive treatment (TPT) or follow-up chest x-rays, but knowledge about the long-term outcome in terms of active TB is sparse. Methods: We performed a retrospective cohort study investigating the long-term outcomes for socially marginalized citizens who were diagnosed with LTBI or who had a positive interferon-gamma release assay (IGRA) but were lost to follow-up. Information on TB examinations, diagnostics, and treatment along with data on death were gathered from medical records from the date of positive IGRA to February 1, 2021. Results: We identified 119 patients with LTBI, 18 of which (15.1%) were diagnosed with TB during the follow-up period (mean, 4.5 years). TPT was completed by 36.1% and the TB incidence rate ratio of those completing TPT to those who did not was 0.78 (confidence interval, 0.25-2.17; P =.6). Of the patients with TB, 16 of 18 achieved treatment success. Conclusion: High rates of TB development are found among socially marginalized citizens with LTBI. Overall incidence of TB was not significantly reduced by administration of TPT, although TB did not develop in the first 2 years following TPT.

Original languageEnglish
JournalInternational Journal of Infectious Diseases
ISSN1201-9712
DOIs
Publication statusE-pub ahead of print - 26. Feb 2022

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Publisher Copyright:
© 2022 The Authors

Keywords

  • Hard-to-reach population
  • Latent tuberculosis infection
  • Preventive treatment
  • Tuberculosis risk factors

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