title: Risk of developing tuberculosis disease among persons diagnosed with latent tuberculosis infection in the Netherlands.
abstract: Diagnosis and preventive treatment of latent tuberculosis infection (LTBI) among high-risk groups is recommended to achieve tuberculosis (TB) elimination in low-incidence countries.We studied TB incidence rates among those notified with LTBI in the Netherlands from 2005 to 2013 and analysed associated risk factors. We stratified analyses by target group for screening, and by initiation and completion of preventive treatment.The incidence for those completing, stopping and not receiving preventive treatment was 187, 436 and 355 per 100 000 person-years for contacts of TB patients, respectively, and 63, 96 and 110 per 100 000 person-years for other target groups. The rate ratio for TB development among contacts compared to other target groups was 3.1 (95% CI 2.0-4.9). In both groups, incidence was highest in the first year after diagnosis. Independent factors associated with progression to TB among contacts were age <5 years and stopping preventive treatment within 28 days compared to those not receiving preventive treatment. Among other target groups, being foreign born was the only risk factor associated with the risk of developing TB.We conclude that the epidemiological impact of preventive treatment is highest in contacts of TB patients and limited in other target groups for LTBI management in the Netherlands.
authors: KNCV Tuberculosis Foundation, The Hague, The Netherlands connie.erkens@kncvtbc.org.
authors: Connie G M
authors: CG
authors: Erkens
authors: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors: Erika
authors: E
authors: Slump
authors: Public Health Service (GGD) Limburg-Noord, Roermond, The Netherlands.
authors: Maurits
authors: M
authors: Verhagen
authors: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors: Henrieke
authors: H
authors: Schimmel
authors: KNCV Tuberculosis Foundation, The Hague, The Netherlands.|Dept of Global Health, Academic Medical Center, Amsterdam, The Netherlands.|Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors: Frank
authors: F
authors: Cobelens
authors: KNCV Tuberculosis Foundation, The Hague, The Netherlands.|Dept of Global Health, Academic Medical Center, Amsterdam, The Netherlands.|Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors: Susan
authors: S
authors: van den Hof
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D055985:Latent Tuberculosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D061665:Time-to-Treatment; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult