A central aim of the E-DETECT TB project is to establish a database of latent and active TB in Europe starting with Italy, Sweden, the Netherlands and the UK to inform epidemiological analysis and future interventions to control TB.   Professor Knut Lönnroth of Stockholm’s Karolinska Institutet reports on their progress to date.

“Despite international guidelines from ECDC and WHO on screening for active tuberculosis (TB) and latent TB infection (LTBI), there is no concrete guidance on which migrant sub-groups should be targeted, when and where they should be screened, or on the best approach for implementation of screening programmes to ensure optimal completion of the cascade of care from screening to completion of treatment.  The present lack of consolidated data on the process and outcomes of screening hampers the development of such guidance.

“E-DETECT Work Package 6 (WP6) aims to establish a multi-country database (starting with Italy, The Netherlands, Sweden and UK) on screening for latent and active TB in migrants, in order to collate and evaluate data on TB screening in immigrants to low incidence countries.

“Based on a careful mapping of available data on TB screening and opportunities to improve existing data collection and collation mechanism, the WP6 partners have developed an agreed protocol for data sharing, analysis and dissemination.  The database will now be created and data transfer will start quarter 3-4 2017.  Data analysis will start quarter 1 2018, with the following main objectives:

1. To determine TB screening coverage, target groups and reasons for screening.
2. To determine results of the screening and prevalence of infection and disease in different groups.
3. To determine TB/LTBI treatment uptake and completion
4. To estimate reactivation rates of active TB amongst LTBI screening cohort (after the project period).

“While identifying challenges for data extraction and collation, the E-DETECT project has already helped improve data availability and quality.  The process of analysing existing data sources and developing this protocol has stimulated discussions on how data recording and reporting can be improved and standardised.  The monitoring and evaluation systems for the migrant TB screening project in Italy under E-DETECT WP5 is now fully harmonized with the WP6 protocol.  Moreover, in Sweden (starting in Stockholm), the E-DETECT TB project has helped facilitate improvements in the data recording and reporting so that it migrant TB screening data now includes directly extractible variables on screening done, screening results, country of origin, age and sex, which was previously cumbersome to extract and analyse.

“The E-DETECT TB project, including WP6, has already been widely disseminated in international conferences and in peer-reviewed journals.  One result of this is that there is growing interest among other EU member states to become part of the project and share data.  Once the database has been created, E-DETECT TB WP6 will invite other countries to contribute data to the database.  We will also seek opportunities to link our database with other existing research databases on TB screening, including data on LTBI reactivation, in order to broaden the scope of pooled analyses.”