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. 2022 Jan 28;7(2):19.
doi: 10.3390/tropicalmed7020019.

Evaluating the Quality of Latent Tuberculosis Infection Screening in Ireland: A Single-Centre Retrospective Cohort Study

James O'Connell  1 , Joy Oguntuase  2 , Brian Li  3 , Cora McNally  1   4 , Debbi Stanistreet  5 , Samuel McConkey  1   4 , Eoghan de Barra  1   4
Affiliations

Evaluating the Quality of Latent Tuberculosis Infection Screening in Ireland: A Single-Centre Retrospective Cohort Study

James O'Connell et al. Trop Med Infect Dis. .

Abstract

Ireland is a country with a low incidence of tuberculosis (TB) (5.6 cases per 100,000 population in 2019) that should be aiming for TB elimination (fewer than 1 case per million of population). To achieve TB elimination in low-incidence countries, programmatic latent tuberculosis infection (LTBI) management is important. This requires high-quality latent tuberculosis infection (LTBI) screening.

Aim: To assess the quality of LTBI screening in a tertiary centre in Ireland using a framework.

Methods: A retrospective review of the health care records of patients screened for TB in a tertiary centre in Ireland using an interferon-gamma release assay (IGRA) between 2016 and 2018 was performed. Three domains from the Institute of Medicine framework for health care quality, effectiveness, efficiency, and equity, were applied to measure the quality of LTBI screening.

Results: Forty patients had LTBI and an indication for treatment, of whom 20% (8/40) were not offered treatment by the health care provider, 2.5% (1/40) did not accept treatment, and 10% (4/40) did not complete treatment. Seventy-five percent (6/8) of patients not offered treatment were non-Irish. The cost of screening per LTBI case identified was EUR 2048.

Conclusions: This study evaluated the quality of LTBI screening using a framework and identified that LTBI screening in this tertiary centre needs to be scaled and expanded, and that treatment initiation needs to be improved, particularly among non-Irish nationals.

Keywords: cost analysis; effectiveness; equity; latent tuberculosis infection; quality of care.

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Conflict of interest statement

The authors declare they have no conflict of interest.

Figures

Figure 1
Figure 1
Framework, domains, and measures applied.
Figure 2
Figure 2
Cascade of interferon-gamma release assay testing performed to screen for latent tuberculosis infection.
Figure 3
Figure 3
Cascade of interferon-gamma release assay testing performed during investigation for active tuberculosis.
See this image and copyright information in PMC

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