Risk for latent and active tuberculosis in Germany

Area of Science:

• Infectious Diseases
• Public Health
• Epidemiology

Background:

• Latent tuberculosis infection (LTBI) affects a significant portion of the population.
• Identifying risk factors for LTBI progression to active pulmonary tuberculosis (PTB) is crucial for disease control.

Purpose of the Study:

• To investigate risk factors associated with latent tuberculosis infection (LTBI) and active pulmonary tuberculosis (PTB) in Germany.
• To evaluate the predictive value of interferon-gamma release assay (IGRA) for active tuberculosis development.

Main Methods:

• Recruitment of healthy household contacts (HHCs), healthcare workers (HCWs), and PTB patients across 18 German centers.
• Utilized interferon-gamma release assay (IGRA) for LTBI testing.
• Compared IGRA-positive and IGRA-negative contacts to identify LTBI risk factors.
• Compared PTB patients with HHCs to identify PTB risk factors.

Main Results:

• LTBI prevalence was 34.5% in HHCs and 38.9% in HCWs.
• For HCWs, risk factors for LTBI included caring for coughing patients and long-term nursing roles.
• For HHCs, risk factors for LTBI included having a diseased partner and substance dependency.
• Active PTB was associated with male sex, low body weight, alcoholism, glucocorticoid therapy, and diabetes.

Conclusions:

• Positive IGRA responses are frequent in exposed HHCs and HCWs in Germany.
• IGRA results are poor predictors for the development of active tuberculosis.
• Specific risk factors identified for LTBI and PTB require targeted public health interventions.