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Home / The International Journal of Tuberculosis and Lung Disease, Volume 27, Number 10

Outcomes of TB contact tracing and predictors of success: a 10-year retrospective cohort analysis in Birmingham, UK

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BACKGROUND: Contacts of TB cases in Birmingham and Solihull, UK, are offered screening for TB infection. Between 1990 and 2010, only 59.1% of contacts completed screening. The service has since increased screening staff numbers, changed screening locations and increased screening follow-up. Our primary aim was to identify whether screening completion rates have improved. Our secondary aim was to identify predictors of screening completion.

METHODS: This was a retrospective analysis of all contacts of TB patients in Birmingham and Solihull between 1 January 2011 and 31 December 2020, stratified by pulmonary and extrapulmonary TB (PTB or EPTB) index infection. Multiple logistic regression analysis for predictors of screening completion was performed.

RESULTS: A total of 3,255 index cases and 27,820 contacts were identified. TB incidence has declined, in keeping with national trends. Screening completion has improved from 59.1% of contacts to 74.9% overall since service improvements were made, with improvement in screening completion for contacts of both PTB and EPTB index cases (OR 1.087, 95% CI 1.074–1.101; P < 0.001) and (OR 1.048, 95% CI 1.019–1.078; P = 0.001), respectively.

CONCLUSIONS: Changes made to the TB service have improved screening outcomes over the last decade. Significant predictors of screening completion have been identified, highlighting areas for targeted resource allocation.

Keywords: United Kingdom; contact screening; tuberculosis

Document Type: Research Article

Affiliations: 1: Warwick Medical School, University of Warwick, Warwick 2: University Hospitals Birmingham NHS Foundation Trust, Birmingham 3: Test Evaluation Research Group, Institute of Applied Health Research, and 4: University Hospitals Birmingham NHS Foundation Trust, Birmingham, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK 5: Warwick Medical School, University of Warwick, Warwick, University Hospitals Birmingham NHS Foundation Trust, Birmingham

Publication date: October 1, 2023

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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