PMID- 38023560
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231202
IS  - 2328-8957 (Print)
IS  - 2328-8957 (Electronic)
IS  - 2328-8957 (Linking)
VI  - 10
IP  - 11
DP  - 2023 Nov
TI  - Prior Screening for Latent Tuberculosis Among Patients Diagnosed With 
      Tuberculosis Disease: Missed Opportunities?
PG  - ofad545
LID - 10.1093/ofid/ofad545 [doi]
LID - ofad545
AB  - BACKGROUND: California has the largest number of tuberculosis (TB) disease cases 
      in the United States. This study in a large California health system assessed 
      missed opportunities for latent tuberculosis (LTBI) screening among patients with 
      TB disease. METHODS: Kaiser Permanente Southern California patients who were >/=18 
      years old with membership for >/=24 months during the study period from 1 January 
      2008 to 31 December 2019 were included. Prior LTBI test (tuberculin skin test or 
      interferon-gamma release assay) or diagnosis code prior to TB disease diagnosis was 
      assessed among patients with observed TB disease (confirmed by polymerase chain 
      reaction and/or culture). In the absence of current treatment practices, more 
      patients screened for LTBI may have developed TB disease. We estimated 
      hypothetical TB disease cases prevented by multiplying LTBI progression rates by 
      the number of LTBI-positive patients prescribed treatment. RESULTS: A total of 
      1289 patients with observed TB disease were identified; 148 patients were LTBI 
      positive and 84 were LTBI negative. Patients not prescreened for LTBI made up 
      82.0% of observed TB disease cases (1057/1289). Adding the hypothetical maximum 
      estimate for prevented cases decreased the percentage of patients who were not 
      prescreened for LTBI to 61.7% [1057/(1289 + 424)]. CONCLUSIONS: One-fifth of 
      patients were screened for LTBI prior to their active TB diagnosis. Assuming the 
      upper bound of cases prevented through current screening, almost 62% of TB 
      disease patients were never screened for LTBI. Future work to elucidate gaps in 
      LTBI screening practices and to identify opportunities to improve screening 
      guidelines is needed.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of 
      Infectious Diseases Society of America.
FAU - Fischer, Heidi
AU  - Fischer H
AUID- ORCID: 0000-0001-5343-0002
AD  - Department of Research and Evaluation, Kaiser Permanente Southern California, 
      Pasadena, California, USA.
FAU - Qian, Lei
AU  - Qian L
AD  - Department of Research and Evaluation, Kaiser Permanente Southern California, 
      Pasadena, California, USA.
FAU - Li, Zhuoxin
AU  - Li Z
AD  - Department of Research and Evaluation, Kaiser Permanente Southern California, 
      Pasadena, California, USA.
FAU - Garba, Saadiq
AU  - Garba S
AD  - Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School 
      of Medicine, Pasadena, California, USA.
FAU - Bruxvoort, Katia J
AU  - Bruxvoort KJ
AD  - Department of Research and Evaluation, Kaiser Permanente Southern California, 
      Pasadena, California, USA.
AD  - Department of Epidemiology, University of Alabama at Birmingham, Birmingham, 
      Alabama, USA.
FAU - Skarbinski, Jacek
AU  - Skarbinski J
AD  - Division of Research, Kaiser Permanente Northern California, Oakland, California, 
      USA.
AD  - Department of Infectious Diseases, Oakland Medical Center, Kaiser Permanente 
      Northern California, Oakland, California, USA.
FAU - Ku, Jennifer H
AU  - Ku JH
AD  - Department of Research and Evaluation, Kaiser Permanente Southern California, 
      Pasadena, California, USA.
FAU - Lewin, Bruno J
AU  - Lewin BJ
AD  - Department of Family Medicine, Kaiser Permanente Los Angeles Medical Center, Los 
      Angeles, California, USA.
AD  - Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of 
      Medicine, Pasadena, California, USA.
FAU - Mahale, Parag S
AU  - Mahale PS
AD  - Department of Research and Evaluation, Kaiser Permanente Southern California, 
      Pasadena, California, USA.
FAU - Shaw, Sally F
AU  - Shaw SF
AD  - Department of Research and Evaluation, Kaiser Permanente Southern California, 
      Pasadena, California, USA.
FAU - Spence, Brigitte C
AU  - Spence BC
AD  - Department of Research and Evaluation, Kaiser Permanente Southern California, 
      Pasadena, California, USA.
FAU - Tartof, Sara Y
AU  - Tartof SY
AUID- ORCID: 0000-0003-2336-8476
AD  - Department of Research and Evaluation, Kaiser Permanente Southern California, 
      Pasadena, California, USA.
AD  - Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School 
      of Medicine, Pasadena, California, USA.
LA  - eng
GR  - R01 AI151072/AI/NIAID NIH HHS/United States
PT  - Journal Article
DEP - 20231101
PL  - United States
TA  - Open Forum Infect Dis
JT  - Open forum infectious diseases
JID - 101637045
PMC - PMC10651207
COIS- Potential conflicts of interest. The authors: No reported conflicts of interest.
EDAT- 2023/11/29 18:43
MHDA- 2023/11/29 18:44
PMCR- 2023/11/01
CRDT- 2023/11/29 15:50
PHST- 2023/08/18 00:00 [received]
PHST- 2023/10/30 00:00 [accepted]
PHST- 2023/11/29 18:44 [medline]
PHST- 2023/11/29 18:43 [pubmed]
PHST- 2023/11/29 15:50 [entrez]
PHST- 2023/11/01 00:00 [pmc-release]
AID - ofad545 [pii]
AID - 10.1093/ofid/ofad545 [doi]
PST - epublish
SO  - Open Forum Infect Dis. 2023 Nov 1;10(11):ofad545. doi: 10.1093/ofid/ofad545. 
      eCollection 2023 Nov.