Effectiveness and outcomes of air travel-related TB incident follow-up: a systematic review.

Autor:	Maynard-Smith L; National Infection Service, Public Health England, London, UK.; Hospital for Tropical Diseases, London, UK.; C.S. Brown and L. Maynard-Smith contributed equally to this article as lead authors and supervised the work., Brown CS; National Infection Service, Public Health England, London, UK.; Dept of Infection, Royal Free Hospital, London, UK.; C.S. Brown and L. Maynard-Smith contributed equally to this article as lead authors and supervised the work., Harris RJ; National Infection Service, Public Health England, London, UK., Hodkinson P; Aerospace Medicine Group, King's College London, London, UK., Tamne S; National Infection Service, Public Health England, London, UK., Anderson SR; National Infection Service, Public Health England, London, UK., Zenner D; Institute for Global Health, University College London, London, UK.
Jazyk:	angličtina
Zdroj:	The European respiratory journal [Eur Respir J] 2021 May 06; Vol. 57 (5). Date of Electronic Publication: 2021 May 06 (Print Publication: 2021).
DOI:	10.1183/13993003.00013-2020
Abstrakt:	The World Health Organization (WHO) recommends following up passengers after possible exposure to a case of infectious tuberculosis (TB) during air travel. This is time-consuming and difficult, and increasingly so with higher numbers each year of flights and passengers to and from countries with high TB endemicity. This paper systematically reviews the literature on contact tracing investigations after a plane exposure to active pulmonary TB. Evidence for in-flight transmission was assessed by reviewing the positive results of contacts without prior risk factors for latent TB.A search of Medline, EMBASE, BIOSIS, Cochrane Library and Database of Systematic Reviews was carried out, with no restrictions on study design, index case characteristics, duration of flight or publication date.In total, 22 papers were included, with 469 index cases and 15 889 contacts. Only 26.4% of all contacts identified completed screening after exposure. The yield of either a single positive tuberculin skin test (TST) or a TST conversion attributable to in-flight transmission was between 0.19% (95% CI 0.13%-0.27%) and 0.74% (95% CI 0.61%-0.88%) of all contacts identified (0.00%, 95% CI 0.00%-0.00% and 0.13%, 95% CI 0.00%-0.61% in random effects meta-analysis). The main limitation of this study was heterogeneity of reporting.The evidence behind the criteria for initiating investigations is weak and it has been widely demonstrated that active screening of contacts is labour-intensive and unlikely to be effective. Based on our findings, formal comprehensive contact tracing may be of limited utility following a plane exposure. Competing Interests: Conflict of interest: L. Maynard-Smith has nothing to disclose. Conflict of interest: C.S. Brown has nothing to disclose. Conflict of interest: R.J. Harris has nothing to disclose. Conflict of interest: P. Hodkinson has nothing to disclose. Conflict of interest: S. Tamne has nothing to disclose. Conflict of interest: S.R. Anderson has nothing to disclose. Conflict of interest: D. Zenner has nothing to disclose. (Copyright ©ERS 2021.)
Databáze:	MEDLINE
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