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Study backs GP screening of new migrants for latent TB

GP screening of recent migrants for latent tuberculosis (TB) infection when they register with them could prevent the majority of new cases in this group of patients, suggests a UK study.

For most of those cases of TB that could not have been prevented through screening on registration, the main reason was the patient had not registered at all or had delayed in registering so they were not registered far enough in advance of diagnosis.

Researchers looked at 857 new diagnoses of TB made among foreign-born patients, who arrived in the UK after 1999 and were diagnosed with TB between 2000 and 2010.

They found 551 (60%) of these cases were diagnosed more than six months after patients registered with a practice, and could potentially have been prevented if the patients had been screened and treated for latent TB infection when they first registered.

Reporting the findings in the journal Thorax, the researchers called for more to be done to encourage newly arrived immigrants to register in primary care, to help pick up the infection before it is too late to stop active TB developing.

The team concluded: ‘Our data support the principle of immigrant latent TB infection screening at the time of primary care registration as a rational and effective strategy if implemented at a regional level in a high-burden setting.’

The findings come after Public Health England announced plans to introduce a nationally co-ordinated latent TB infection screening programme in primary care, targeting recently-arrived immigrants from countries with TB incidences above 150 per 100,000, in order to tackle the growing burden of TB in some urban areas.

Thorax 2013; available online 19 November


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