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O15 IGRA testing for latent tuberculosis in commercial sex workers
  1. Nadia Khatib1,
  2. Ria Daly1,
  3. Martin Dedicoat1,
  4. Alison Larkins2,
  5. Claire Robertson1
  1. 1Heartlands Hospital, Birmingham, UK
  2. 2SAFE Project, Birmingham, UK

Abstract

Background/introduction Tuberculosis (TB) is a significant public health issue in Birmingham. Targeting ‘hard to reach’ groups, such as commercial sex workers (CSW), is a priority for Public Health England. Additionally, a large proportion of CSW in Birmingham are from Romania, where TB prevalence is high. We undertook a project to look for latent TB amongst CSW attending an outreach sexual health clinic.

Aim(s)/objectives To determine the:

  • feasibility of testing and following up this group.

  • prevalence of latent TB in this group.

Methods We offered Interferon Gamma Release Assay (IGRA) testing to all CSW attending clinic between 29.04.2014 and 24.11.2014.

Results Seventy-one women were screened. Twenty-six were IGRA positive. Of these, eighteen were followed up in TB clinic:

  • Three had results suggesting previous TB and were discharged from clinic without treatment.

  • Eleven were diagnosed with latent TB and treated accordingly.

  • Four were diagnosed with active TB and are on appropriate therapy.

  • Eight were lost to follow up.

Discussion/conclusion We demonstrated that testing is acceptable and feasible to this group. Follow-up was challenging but a review of the referral process led to improved attendance rates. To improve adherence, we used weekly rifapentine and isoniazid for latent TB in selected cases. We are the only unit in UK to have used this regimen.

The prevalence rate of latent TB was higher than anticipated at 15%. Identifying active TB cases further demonstrated that this is a group worth targeting. These preliminary results led to an extension of this project.

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