Modeling the Impact of Recommendations for Primary Care-Based Screening for Latent Tuberculosis Infection in California
| Autor: | Alex J. Goodell, Pennan M. Barry, James G. Kahn, Adam Readhead, Andrea Parriott, Jennifer Flood, Haleh Ashki, Priya B. Shete |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Tuberculosis Policy and Administration Antitubercular Agents Emigrants and Immigrants Primary care Nursing 01 natural sciences Risk Assessment California Residential Facilities 03 medical and health sciences Immunocompromised Host 0302 clinical medicine Rare Diseases Clinical Research Latent Tuberculosis Component (UML) Medicine Humans Mass Screening 030212 general & internal medicine guidelines simulation modeling 0101 mathematics Intensive care medicine tuberculosis elimination Latent tuberculosis Primary Health Care business.industry Prevention Research 010102 general mathematics Public Health Environmental and Occupational Health Age Factors medicine.disease LTBI Markov Chains Infectious Diseases Good Health and Well Being Practice Guidelines as Topic Public Health and Health Services Public Health Guideline Adherence business Infection |
| Zdroj: | Public Health Rep Public health reports (Washington, D.C. : 1974), vol 135, iss 1_suppl |
| ISSN: | 1468-2877 |
| Popis: | Objective Targeted testing and treatment of persons with latent tuberculosis infection (LTBI) is a critical component of the US tuberculosis (TB) elimination strategy. In January 2016, the California Department of Public Health issued a tool and user guide for TB risk assessment (California tool) and guidance for LTBI testing, and in September 2016, the US Preventive Services Task Force (USPSTF) issued recommendations for LTBI testing in primary care settings. We estimated the epidemiologic effect of adherence to both recommendations in California. Methods We used an individual-based Markov micro-simulation model to estimate the number of cases of TB disease expected through 2026 with baseline LTBI strategies compared with implementation of the USPSTF or California tool guidance. We estimated the risk of LTBI by age and country of origin, the probability of being in a targeted population, and the probability of presenting for primary care based on available data. We assumed 100% adherence to testing guidance but imperfect adherence to treatment. Results Implementation of USPSTF and California tool guidance would result in nearly identical numbers of tests administered and cases of TB disease prevented. Perfect adherence to either recommendation would result in approximately 7000 cases of TB disease averted (40% reduction compared with baseline) by 2026. Almost all of this decline would be driven by a reduction in the number of cases among non–US-born persons. Conclusions By focusing on the non–US-born population, adherence to LTBI testing strategies recommended by the USPSTF and the California tool could substantially reduce the burden of TB disease in California in the next decade. |
| Databáze: | OpenAIRE |
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