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Latent tuberculosis infection: the final frontier of tuberculosis elimination in the USA.
Lancet Infect Dis. 2017 10; 17(10):e327-e333.LI

Abstract

Since 1989, the USA has been pursuing the goal of tuberculosis elimination. After substantial progress during the past two decades, the rate of tuberculosis cases in the USA each year has now levelled off and remains well above the elimination threshold. Both epidemiological data and modelling underline the necessity of addressing latent tuberculosis infection if further progress is to be made in eliminating the disease. In this Personal View we explore next steps towards elimination. Given the estimated prevalence of latent tuberculosis infection, compared with the limited testing and treatment that currently occur, a major new effort is required. This effort should consist of a surveillance system or registry to monitor progress, scale-up of targeted testing for latent tuberculosis infection in at-risk populations, scale-up of short-course treatment regimens, engagement of affected communities and medical providers who serve those communities, and increased public health staffing for implementation and oversight. Such an effort would benefit greatly from the development of new tools, such as tests that better indicate reactivation risk, and even shorter latent tuberculosis infection treatment regimens than currently exist.

Authors+Show Affiliations

National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: plobue@cdc.gov.National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28495525

Citation

LoBue, Philip A., and Jonathan H. Mermin. "Latent Tuberculosis Infection: the Final Frontier of Tuberculosis Elimination in the USA." The Lancet. Infectious Diseases, vol. 17, no. 10, 2017, pp. e327-e333.
LoBue PA, Mermin JH. Latent tuberculosis infection: the final frontier of tuberculosis elimination in the USA. Lancet Infect Dis. 2017;17(10):e327-e333.
LoBue, P. A., & Mermin, J. H. (2017). Latent tuberculosis infection: the final frontier of tuberculosis elimination in the USA. The Lancet. Infectious Diseases, 17(10), e327-e333. https://doi.org/10.1016/S1473-3099(17)30248-7
LoBue PA, Mermin JH. Latent Tuberculosis Infection: the Final Frontier of Tuberculosis Elimination in the USA. Lancet Infect Dis. 2017;17(10):e327-e333. PubMed PMID: 28495525.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Latent tuberculosis infection: the final frontier of tuberculosis elimination in the USA. AU - LoBue,Philip A, AU - Mermin,Jonathan H, Y1 - 2017/05/08/ PY - 2016/07/26/received PY - 2017/01/23/revised PY - 2017/02/01/accepted PY - 2017/5/13/pubmed PY - 2017/10/3/medline PY - 2017/5/13/entrez SP - e327 EP - e333 JF - The Lancet. Infectious diseases JO - Lancet Infect Dis VL - 17 IS - 10 N2 - Since 1989, the USA has been pursuing the goal of tuberculosis elimination. After substantial progress during the past two decades, the rate of tuberculosis cases in the USA each year has now levelled off and remains well above the elimination threshold. Both epidemiological data and modelling underline the necessity of addressing latent tuberculosis infection if further progress is to be made in eliminating the disease. In this Personal View we explore next steps towards elimination. Given the estimated prevalence of latent tuberculosis infection, compared with the limited testing and treatment that currently occur, a major new effort is required. This effort should consist of a surveillance system or registry to monitor progress, scale-up of targeted testing for latent tuberculosis infection in at-risk populations, scale-up of short-course treatment regimens, engagement of affected communities and medical providers who serve those communities, and increased public health staffing for implementation and oversight. Such an effort would benefit greatly from the development of new tools, such as tests that better indicate reactivation risk, and even shorter latent tuberculosis infection treatment regimens than currently exist. SN - 1474-4457 UR - https://www.unboundmedicine.com/medline/citation/28495525/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1473-3099(17)30248-7 DB - PRIME DP - Unbound Medicine ER -