Knowledge, attitudes, beliefs, and stigma related to latent tuberculosis infection: a qualitative study among Eritreans in the Netherlands

Spruijt, Ineke; Haile, Dawit Tesfay; Hof, Susan van den; Fiekert, Kathy; Jansen, Niesje; Jerene, Degu; Klinkenberg, Eveline; Leimane, Ieva; Suurmond, Jeanine

doi:10.21203/rs.3.rs-15581/v3

Cited by 1 publication

(1 citation statement)

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“…They require the burden of either phlebotomy from, or administration of skin tests to, otherwise healthy individuals for the purposes of public health. Participants may be harmed by a stigmatising label of "TB infection", and the potential toxicity of preventive therapy for uncertain benefit [98].…”

Section: Is Mtb Infection Surveillance Ethical and Acceptable?mentioning

confidence: 99%

Know your tuberculosis epidemic–Is it time to add Mycobacterium tuberculosis immunoreactivity back into global surveillance?

Rickman

Kamchedzera²,

Schwalb³

et al. 2022

PLOS Glob Public Health

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Tuberculosis (TB) still causes 1.5 million deaths globally each year. Over recent decades, slow and uneven declines in TB incidence have resulted in a falling prevalence of TB disease, which increasingly concentrates in vulnerable populations. Falling prevalence, while welcome, poses new challenges for TB surveillance. Cross-sectional disease surveys require very large sample sizes to accurately estimate disease burden, and even more participants to detect trends over time or identify high-risk areas or populations, making them prohibitively resource-intensive. In the past, tuberculin skin surveys measuring Mycobacterium tuberculosis (Mtb) immunoreactivity were widely used to monitor TB epidemiology in high-incidence settings, but were limited by challenges with both delivering and interpreting the test. Here we argue that the shifting epidemiology of tuberculosis, and the development of new tests for Mtb infection, make it timely and important to revisit the strategy of TB surveillance based on infection or immunoreactivity. Mtb infection surveys carry their own operational challenges and fundamental questions, for example: around survey design and frequency; which groups should be included; how the prevalence of immunoreactivity in a population should be used to estimate force of infection; how individual results should be interpreted and managed; and how surveillance can be delivered efficiently and ethically. However, if these knowledge gaps are addressed, the relative feasibility and lower costs of Mtb infection surveillance offer a powerful and affordable opportunity to better “know your TB epidemic”, understand trends, identify high-risk and underserved communities, and tailor public health responses to dynamic epidemiology.

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Section: Is Mtb Infection Surveillance Ethical and Acceptable?mentioning

confidence: 99%