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An Automated Culture System for Use in Preclinical Testing of Host-Directed Therapies for Tuberculosis
Published on: August 16, 2021
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Pre-placement screening for tuberculosis in healthcare workers
P Giri1, S Basu2, T Sargeant1
1Sheffield Occupational Health Service, Silverwood, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
Occupational Medicine (Oxford, England)
|August 20, 2014
Summary
A one-step interferon gamma release assay (IGRA) screening programme for new healthcare workers (HCWs) in the UK appears feasible and safe for tuberculosis (TB) detection. This approach could lead to significant cost savings for occupational health services.
Area of Science:
- Occupational Health
- Infectious Disease Epidemiology
- Public Health Policy
Background:
- Healthcare workers (HCWs) face occupational risks for tuberculosis (TB) transmission.
- Current UK national guidance lacks clarity on optimal pre-placement TB screening for new HCWs.
- The appropriateness of a single-step interferon gamma release assay (IGRA) screening programme requires evaluation.
Purpose of the Study:
- To assess the feasibility of an IGRA-only TB screening programme for new HCWs.
- To identify potential cost savings associated with an IGRA-only screening approach.
- To evaluate the safety of an IGRA-only strategy by monitoring discordant test results.
Main Methods:
- Retrospective analysis of IGRA and tuberculin skin tests (TST) over three years.
- Follow-up of HCWs with discordant IGRA-negative, TST-positive results to monitor for active TB.
- Estimation of cost savings by comparing a hypothetical IGRA-only programme to the existing two-step process.
Main Results:
- 8% (96/1258) of HCWs had positive IGRA results.
- None of the 10 individuals with markedly discordant results (IGRA negative, TST >15 mm) developed active TB.
- An IGRA-only programme could save an estimated £20,453 annually.
Conclusions:
- An IGRA-only TB screening programme for new HCWs in the UK is potentially feasible and safe.
- The study suggests substantial cost savings are achievable with an IGRA-only approach.
- Further follow-up is needed to definitively confirm the long-term safety of this screening strategy.
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