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Letter to the Editor|Articles in Press

Identifying opportunities to improve the microbiological diagnosis of tuberculosis in a low endemic urban setting

Published:March 09, 2023DOI:https://doi.org/10.1016/j.jinf.2023.03.008
Identifying opportunities to improve the microbiological diagnosis of tuberculosis in a low endemic urban setting
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      Tuberculosis (TB) remains a leading cause of morbidity and mortality worldwide with approximately 10 million new cases per year.
      WHO
      Global tuberculosis report 2021.
      Glob Tuberc Rep. 2021;
      TB rates in the UK have been declining since 2011, attributed to TB control programs providing universal access to rapid diagnosis and treatment.
      • Glaziou P.
      • Floyd K.
      • Raviglione M.
      Trends in tuberculosis in the UK.
      Thorax. 2018; 73: 702https://doi.org/10.1136/thoraxjnl-2018-211537
      , 

      UKHSA. TB Action Plan for England, 2021 to 2026, 〈https://www.gov.uk/government/publications/tuberculosis-tb-action-plan-for-england〉 (2021).

      However, in 2019 the decline reversed due to factors including increased migration, an aging population, and co-morbidities.

      UKHSA. TB Action Plan for England, 2021 to 2026, 〈https://www.gov.uk/government/publications/tuberculosis-tb-action-plan-for-england〉 (2021).

      Birmingham has one of the highest TB incidences in the UK with 9.2 cases per 100,000 reported in 2020, compared to 7.3 across England.

      UKHSA. Tuberculosis in the West Midlands Annual review (2020 data), 〈https://www.gov.uk/government/publications/tuberculosis-tb-regional-reports〉 (2020).

      NICE guidance recommends diagnosing pulmonary TB with three sputum samples or tissue biopsy for extra-pulmonary TB.

      NICE. Tuberculosis NICE guideline [NG33], 〈https://www.nice.org.uk/guidance/ng33〉 2016.

      A positive microbiological culture is necessary to confirm diagnosis and determine drug susceptibility for effective treatment. Only 59% of new TB cases were microbiologically confirmed in England in 2020. The UKHSA aims to increase culture confirmation to 80% for pulmonary TB by 2024–2025.

      UKHSA. TB Action Plan for England, 2021 to 2026, 〈https://www.gov.uk/government/publications/tuberculosis-tb-action-plan-for-england〉 (2021).

      In the West Midlands, the proportion of culture-confirmed cases has been stable at 58% between 2018 and 2020.

      UKHSA. Tuberculosis in the West Midlands Annual review (2020 data), 〈https://www.gov.uk/government/publications/tuberculosis-tb-regional-reports〉 (2020).

      Few studies have examined factors influencing a positive culture apart from site of infection and clinical symptoms like cough. In Denmark, a recent study analyzed the effect of mental illness and substance use and discovered that individuals in these groups had higher odds of developing TB and were more likely to test positive in a smear test.
      • Nordholm A.C.
      • Andersen A.B.
      • Wejse C.
      • Norman A.
      • Ekstrøm C.T.
      • Andersen P.H.
      • et al.
      Mental illness, substance abuse, and tuberculosis risk.
      J Infect. 2023; (Jan 28:S0163-4453(23)00056-7)https://doi.org/10.1016/j.jinf.2023.01.035
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      References

        • WHO
        Global tuberculosis report 2021.
        Glob Tuberc Rep. 2021;
        View in Article
        • Glaziou P.
        • Floyd K.
        • Raviglione M.
        Trends in tuberculosis in the UK.
        Thorax. 2018; 73: 702https://doi.org/10.1136/thoraxjnl-2018-211537
        View in Article

      3. UKHSA. TB Action Plan for England, 2021 to 2026, 〈https://www.gov.uk/government/publications/tuberculosis-tb-action-plan-for-england〉 (2021).

        View in Article

      4. UKHSA. Tuberculosis in the West Midlands Annual review (2020 data), 〈https://www.gov.uk/government/publications/tuberculosis-tb-regional-reports〉 (2020).

        View in Article

      5. NICE. Tuberculosis NICE guideline [NG33], 〈https://www.nice.org.uk/guidance/ng33〉 2016.

        View in Article
        • Nordholm A.C.
        • Andersen A.B.
        • Wejse C.
        • Norman A.
        • Ekstrøm C.T.
        • Andersen P.H.
        • et al.
        Mental illness, substance abuse, and tuberculosis risk.
        J Infect. 2023; (Jan 28:S0163-4453(23)00056-7)https://doi.org/10.1016/j.jinf.2023.01.035
        View in Article

      7. Seabold, S., and Josef Perktold. Statsmodels: Econometric and statistical modeling with python. In: Proceedings of the 9th Python in Science Conference 2010.

        View in Article
        • Pauli Virtanen R.G.
        • Oliphant T.E.
        • Haberland M.
        • Reddy T.
        • Cournapeau D.
        • Burovski E.
        • et al.
        SciPy 1.0: fundamental algorithms for scientific computing in Python.
        Nat Methods. 2020; 17 (SciPy 1.0 Contributors): 261-272
        View in Article
        • Hayward S.
        • Harding R.M.
        • McShane H.
        • Tanner R.
        Factors influencing the higher incidence of tuberculosis among migrants and ethnic minorities in the UK.
        F1000Res. 2018; 7: 461https://doi.org/10.12688/f1000research.14476.2
        View in Article

      10. UKHSA. Tuberculosis in England: Annual report 2021. 2021.

        View in Article
        • Nguipdop-Djomo P.
        • Rodrigues L.C.
        • Smith P.G.
        • Abubakar I.
        • Mangtani P.
        Drug misuse, tobacco smoking, alcohol and other social determinants of tuberculosis in UK-born adults in England: a community-based case-control study.
        Sci Rep. 2020; 10: 5639https://doi.org/10.1038/s41598-020-62667-8
        View in Article
        • Dheda K.
        • et al.
        The intersecting pandemics of tuberculosis and COVID-19: population-level and patient-level impact, clinical presentation, and corrective interventions.
        Lancet Respir Med. 2022; 10: 603-622https://doi.org/10.1016/S2213-2600(22)00092-3
        View in Article
        • McQuaid C.F.
        • Vassall A.
        • Cohen T.
        • Fiekert K.
        • White R.G.
        The impact of COVID-19 on TB: a review of the data.
        Int J Tube Lung Dis. 2021; 25: 436-446https://doi.org/10.5588/ijtld.21.0148
        View in Article

      Article info

      Publication history

      Published online: March 09, 2023
      Accepted: March 6, 2023

      Publication stage

      In Press Journal Pre-Proof

      Identification

      DOI: https://doi.org/10.1016/j.jinf.2023.03.008

      Copyright

      © 2023 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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