Impact of Routine Quantiferon Testing on Latent Tuberculosis Diagnosis and Treatment in Refugees in Multnomah County, Oregon, November 2009–October 2012
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Interferon-gamma release assays have potentially been transformative to screening programs focused on latent tuberculosis infection (LTBI) in foreign-born persons. We sought to add to this assessment by presenting the impact of a well-established refugee screening and treatment program switching from skin testing to Quantiferon®-TB Gold (QFT). We completed a retrospective cohort of refugees screened for tuberculosis between November 1, 2009–April 30, 2011 (pre-QFT) and May 1, 2011–October 31, 2012 (post-QFT). Among 2244 refugees screened that met the inclusion criteria, there was a significant difference in the proportion of refugees diagnosed with LTBI between the two time periods (p = <0.0001). In multivariate analysis, refugees tested with QFT had a greater odds of treatment initiation (adjusted odds ratio 1.53; 95 % CI 1.02–2.29, p = 0.040). However, test type had no impact on treatment completion (odds ratio 0.88; 95 % CI 0.57–1.36, p = 0.560). Although we demonstrated increased efficiency in LTBI diagnosis in this group, treatment completion rates indicate other barriers to treatment that must be addressed.
KeywordsTuberculosis Diagnosis Latent tuberculosis Refugee Treatment initiation Treatment completion
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