Screening for tuberculosis among high-risk groups attending London emergency departments: a prospective observational study

Abstract

Most tuberculosis (TB) cases in low-incidence settings are thought to be due to reactivation of latent TB infection (LTBI) in high-risk populations [1–3]. Assessment of patients at emergency departments (EDs) is a potential opportunity to achieve early TB diagnosis, and interrupt transmission. An earlier study in London found that 39% of patients diagnosed with TB had attended an ED in the preceding 6 months [4]. Of these, 76% had a chest radiograph performed, of which 86% and 40% were abnormal in cases of pulmonary and extrapulmonary TB, respectively. Attendance at EDs provides an opportunity to identify individuals with LTBI, who may be at risk for progression to active disease and unlikely to engage with healthcare services via other routes. LTBI screening among high-risk groups at EDs could be implemented to identify those at risk of progression to TB disease. Large-scale studies are required to investigate effective TB disease screening strategies in EDs. https://bit.ly/3bTkoOn