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Identifier

000404052

Title

Δείκτης Φυματινικής διαμόλυνσης και ενεργού φυματίωσης σε οικονομικούς μετανάστες.

Alternative Title

Prevalence of active and latent tuberculosis among immigrants

Author

Μαλτεζάκης, Ανδρέας

Reviewer

Τζανάκης, Νικόλαος

Reviewer

Τζιλιγιάννη, Ιωάννα
Σχίζα, Σοφία

Abstract

About one-third of the world population has latent TB infection (LTBI), the majority of which is distributed in 22 high-burden countries. Early diagnosis and treatment of active TB remains the top priority in resource-poor countries with high TB prevalence. Notwithstanding, because LTBI contributes significantly to the pool of active TB cases later on, its diagnosis and treatment is essential, especially in high-risk groups. The lack of a gold standard and several limitations of currently available tools, namely the tuberculin skin test and interferon-γ release assays, are major constraints for LTBI diagnosis. In areas with high TB prevalence, interferon-γ release assays have not shown superiority over the conventional tuberculin skin test and are yet to be systematically studied. Decisions regarding LTBI treatment with isoniazid preventive therapy should be made, keeping in mind the high prevalence of isoniazid resistance in these settings. Although efforts to shorten the LTBI treatment duration are encouraging, most trials have focused on adherence and toxicity. Future trials on short-duration regimens in high-burden settings should address drug efficacy issues as well. LTBI management, therefore, should comprise a targeted screening approach and individualization of LTBI treatment protocols. In addition, efforts should focus on airborne infection control measures in high-burden countries. A high prevalence of drug-resistant TB, the HIV epidemic, and delays in the diagnosis of active TB cases are other major concerns in areas of high TB prevalence. There is ample space for further research in these countries, whose outcomes may strengthen future national guidelines.

Language

Greek

Subject

AIDS-HIV

Epidemiology

HIV

Mycobacteria

Screening policies

Μυκοβακτηρίδιο

Φυματίωση

Issue date

2016-12-13