Policy and practice of programmatic management of latent tuberculosis infection in The Netherlands. (May 2017)

• Record Type: Journal Article
• Authors: de Vries, Gerard; van Hest, Rob; Bakker, Marleen; Erkens, Connie; van den Hof, Susan; Meijer, Wieneke; Oud, Karen; Slump, Erika; van Dissel, Jaap
• Is Part Of: Journal of clinical tuberculosis and other mycobacterial diseases. Volume 7(2017)
• Page Start: 40
• Page End: 48
• Publication Date: 2017-05
• Subjects: Elimination -- Latent tuberculosis infection -- Prevention -- Screening -- Tuberculosis; MPHS Municipal Public Health Service; Tuberculosis -- Periodicals; Mycobacterial diseases -- Periodicals; 616.995
• DOI: 10.1016/j.jctube.2017.02.002
• Languages: English
• ISSNs: 2405-5794

Abstract

Abstract: Latent tuberculosis infection (LTBI) screening and preventive treatment is one of the components of the World Health Organization (WHO) End TB strategy, and particularly relevant for low tuberculosis (TB) incidence countries, i.e. less than 100 TB cases per million population. The Netherlands is such a low-incidence country with traditionally a strong emphasis on programmatic management of LTBI, e.g. examining contacts of infectious TB patients by the public health services. Increasingly, curative services are involved in LTBI management of clinical risk groups. The country recently adopted a five-year strategic national plan recommending LTBI screening of high-risk migrants populations. A monitoring and evaluation system is already in place to measure programme performance and guide policy. Research on LTBI screening of migrants is on-going and results should inform future decisions in scaling-up this intervention. Several challenges remain for programmatic LTBI management, such as securing financial resources and the right professional cadre for implementation; availability of screening tests and drugs; collecting additional data for monitoring and evaluation, in line with the WHO indicators for LTBI programmatic management; developing cultural-sensitive and client-centred education for migrants; reducing patient costs for LTBI screening and preventive treatment; and assessing cost-effectiveness and impact on TB epidemiology.