High rate of transmission among contacts in large London outbreak of isoniazid mono-resistant tuberculosis

Neely, Fiona; Maguire, Helen; Brun, Francisco; Davies, Angharad; Gelb, David; Yates, S

doi:10.1093/pubmed/fdp056

Cited by 24 publications

(25 citation statements)

References 22 publications

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“…For example, we did not incorporate secondary transmission into the economic evaluation, even though the mobile screening unit in particular probably averts several secondary cases by finding highly infectious individuals. For example, in a study of a large ongoing epidemic of isoniazid resistant tuberculosis in London in 2004, 18 researchers found 87 cases with traceable contacts, who had 525 contacts between them. Of these contacts, 355 completed screening and 11% of these screened contacts became cases.…”

Section: Principal Findings Strengths and Limitations Of Studymentioning

confidence: 99%

Dedicated outreach service for hard to reach patients with tuberculosis in London: observational study and economic evaluation

Jit¹,

Stagg²,

Aldridge

et al. 2011

BMJ

140

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Objective To assess the cost effectiveness of the Find and Treat service for diagnosing and managing hard to reach individuals with active tuberculosis.Design Economic evaluation using a discrete, multiple age cohort, compartmental model of treated and untreated cases of active tuberculosis.Setting London, United Kingdom.Population Hard to reach individuals with active pulmonary tuberculosis screened or managed by the Find and Treat service (48 mobile screening unit cases, 188 cases referred for case management support, and 180 cases referred for loss to follow-up), and 252 passively presenting controls from London’s enhanced tuberculosis surveillance system.Main outcome measures Incremental costs, quality adjusted life years (QALYs), and cost effectiveness ratios for the Find and Treat service.Results The model estimated that, on average, the Find and Treat service identifies 16 and manages 123 active cases of tuberculosis each year in hard to reach groups in London. The service has a net cost of £1.4 million/year and, under conservative assumptions, gains 220 QALYs. The incremental cost effectiveness ratio was £6400-£10 000/QALY gained (about €7300-€11 000 or $10 000-$16 000 in September 2011). The two Find and Treat components were also cost effective, even in unfavourable scenarios (mobile screening unit (for undiagnosed cases), £18 000-£26 000/QALY gained; case management support team, £4100-£6800/QALY gained).Conclusions Both the screening and case management components of the Find and Treat service are likely to be cost effective in London. The cost effectiveness of the mobile screening unit in particular could be even greater than estimated, in view of the secondary effects of infection transmission and development of antibiotic resistance.

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Section: Principal Findings Strengths and Limitations Of Studymentioning

confidence: 99%

Dedicated outreach service for hard to reach patients with tuberculosis in London: observational study and economic evaluation

Jit¹,

Stagg²,

Aldridge

et al. 2011

BMJ

140

View full text Add to dashboard Cite

show abstract

“…Overcrowding combined with malnutrition and incomplete therapy of pulmonary tuberculosis (Tb) are factors that have contributed to high rates of multi-drug-resistant Tb in prisons within the former Soviet Union, and the rate of incarceration is reported to be an important determinant of increases in Tb and multi-drug-resistant Tb in Europe and Central Asia [44][45][46] . Contact with prisoners has been recognized as an important factor in the introduction of Tb into communities [47,48] .…”

Section: Cultural Factorsmentioning

confidence: 99%

Emerging New Infections: Importance in Child Health

Seventer

DeLoureiro²,

Hamer

2009

Ann Nestlé [Engl]

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A complex interplay of environmental and human factors, including ecological, genetic, political and socioeconomic factors, is responsible for the emergence and re-emergence of infectious diseases. These factors often have a distinct effect on children and, as a result, emerging infections can have unique impacts on younger populations in terms of both physical health and mental as well as social wellbeing. Children are the most vulnerable members of our society. In order to best protect them from the impact of emerging infectious diseases, it is imperative to understand how factors that determine disease emergence and emerging diseases themselves can affect the young. This will allow us to focus on the most appropriate measures to not only prevent infection of pediatric populations but also prepare for the treatment and care of children when an infectious disease emerges. Influenza is a prototypical emerging/re-emerging infectious disease. Epidemic influenza re-emerges annually in periods between influenza pandemics. Both epidemic and pandemic influenza can have considerable impacts on the wellbeing of children. For over a decade, we have anticipated the mutation of avian influenza (H5N1) into a virus that can be efficiently transmitted between humans. This has resulted in substantial efforts to prepare for a virulent influenza pandemic. Although the pandemic potential of avian influenza has not (yet) been realized, efforts to prepare for a widespread pandemic have not been in vain. The unexpected emergence and rapid spread of the swine flu [influenza A(H1N1)v] has resulted in a worldwide pandemic that has already had profound effects on children and adults. Schools, day care centers, modern transport and international travel have all facilitated the spread of this new influenza strain. Swine flu exemplifies well how environmental and human factors interact to result in the emergence of an infectious disease with unique impacts on children.

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“…El hacinamiento extremo combinado con desnutrición y tratamiento incompleto de la tuberculosis pulmonar (Tb) son factores que han contribuido a las elevadas tasas de Tb resistente a múltiples fármacos en prisiones de la antigua Unión Soviética; al respecto se ha descrito que la tasa de encarcelamientos es un determinante importante de los aumentos de la Tb y la Tb resistente a múltiples fármacos en Europa y Asia Central [44][45][46] . Se ha descubierto que el contacto con los presos es un factor importante para la introducción de Tb en las poblaciones [47,48] .…”

Section: Factores Culturalesunclassified

Nuevas infecciones emergentes: importancia en la salud de los niños

Seventer

DeLoureiro²,

Hamer³

2009

Ann Nestlé [Esp]

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Una interacción compleja entre factores ambientales y humanos, incluyendo factores ecológicos, genéticos, políticos y socioeconómicos, es responsable de la emergencia y la resurgencia de enfermedades infecciosas. Estos factores poseen a menudo un efecto claro sobre los niños y, en consecuencia, las infecciones emergentes pueden ejercer impactos únicos sobre las poblaciones más jóvenes en términos de salud física y mental, así como de bienestar social. Los niños son los miembros más vulnerables de nuestra sociedad. Con el objeto de protegerles mejor frente al impacto de las enfermedades infecciosas emergentes, es imperativo comprender cómo factores que determinan la emergencia de enfermedades y las enfermedades emergentes de por sí pueden afectar al niño. Esto nos permitirá centrarnos en las medidas más apropiadas para no sólo prevenir la infección de poblaciones pediátricas sino también prepararnos para el tratamiento y el cuidado de los niños cuando emerge una enfermedad infecciosa. La gripe es un prototipo de enfermedad infecciosa emergente/resurgente. La gripe epidémica emerge de nuevo cada año en periodos entre las pandemias gripales. Tanto la gripe epidémica como la gripe pandémica pueden ejercer impactos considerables sobre el bienestar de los niños. Durante más de una década hemos previsto la mutación de la gripe aviaria (H5N1) en un virus que puede ser transmitido eficientemente entre humanos. Esto ha dado lugar a esfuerzos considerables para prepararnos frente a una pandemia gripal virulenta. Aunque el potencial pandémico de la gripe aviaria no ha sido tomado (todavía) en consideración, los esfuerzos realizados para prepararnos frente a una pandemia generalizada no han sido en vano. La emergencia imprevista y la rápida propagación de la gripe porcina [gripe A(H1N1)] han dado lugar a una pandemia mundial que ha producido ya efectos considerables sobre niños y adultos. Las escuelas, los hospitales de día, el transporte moderno y los viajes internacionales han facilitado la propagación de esta nueva cepa gripal. La gripe porcina ejemplifica perfectamente cómo interactúan factores ambientales y humanos para dar lugar a la emergencia de una enfermedad infecciosa con impactos únicos sobre los niños.

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High rate of transmission among contacts in large London outbreak of isoniazid mono-resistant tuberculosis

Cited by 24 publications

References 22 publications

Dedicated outreach service for hard to reach patients with tuberculosis in London: observational study and economic evaluation

Dedicated outreach service for hard to reach patients with tuberculosis in London: observational study and economic evaluation

Emerging New Infections: Importance in Child Health

Nuevas infecciones emergentes: importancia en la salud de los niños

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