title: Monitoring latent tuberculosis infection diagnosis and management in the Netherlands.
abstract: Targeted diagnosis and treatment of latent tuberculosis (TB) infection (LTBI) among persons with a high risk of exposure to TB or of developing TB when infected has been performed and monitored routinely in the Netherlands since 1993. We describe trends in target groups, diagnostic methods and treatment regimens, and explore determinants for treatment initiation, treatment completion and adverse events.In total, 37 729 persons were registered with LTBI from 1993 to 2013, of whom 28 931 (77%) started preventive treatment; 82% of those completed preventive treatment and 8% stopped preventive treatment due to adverse events. Two-thirds of the notified cases were detected through contact investigation.Increasing numbers of persons with immunosuppressive disorders, elderly persons and foreign-born persons were notified in recent years, due to policy changes and the introduction of the interferon-γ release assay. Children (96%) and the immunosuppressed (95%) were more likely to start preventive treatment. Children (93%) were also more likely to complete preventive treatment, as were persons treated with rifampicin or rifampicin/isoniazid regimens (91% and 92%, respectively). The latter groups were also 40% less likely to stop preventive treatment due to adverse events.Under these operational conditions, the estimated risk reduction on incident TB in the target population for LTBI management is 40-60%.
authors.affiliation: KNCV Tuberculosis Foundation, The Hague, The Netherlands Connie.erkens@kncvtbc.org.
authors.forename: Connie G M
authors.initials: CG
authors.lastname: Erkens
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Erika
authors.initials: E
authors.lastname: Slump
authors.affiliation: Municipal Public Health Service (GGD) Limburg-Noord, Roermond, The Netherlands.
authors.forename: Maurits
authors.initials: M
authors.lastname: Verhagen
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Henrieke
authors.initials: H
authors.lastname: Schimmel
authors.affiliation: KNCV Tuberculosis Foundation, The Hague, The Netherlands Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Gerard
authors.initials: G
authors.lastname: de Vries
authors.affiliation: KNCV Tuberculosis Foundation, The Hague, The Netherlands Dept of Global Health, Academic Medical Center, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Cobelens
authors.affiliation: KNCV Tuberculosis Foundation, The Hague, The Netherlands Dept of Global Health, Academic Medical Center, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors.forename: Susan
authors.initials: S
authors.lastname: van den Hof
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control; D005260:Female; D006291:Health Policy; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007223:Infant; D007231:Infant, Newborn; D055552:Infectious Disease Medicine / Q000379:methods; D059425:Interferon-gamma Release Tests; D007538:Isoniazid / Q000008:administration & dosage / Q000627:therapeutic use; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D012042:Registries; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use; D012424:Rural Population; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy* / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D007166:Immunosuppressive Agents; D007538:Isoniazid; D012293:Rifampin