Jay Phansalkar , Rajas Karajgikar , Jai Patel , Shauna Williams , Lisa Gittens-Williams , Alfred A. Lardizabal
{"title":"内城医院产前门诊对潜伏性结核感染诊断和治疗的级联护理","authors":"Jay Phansalkar , Rajas Karajgikar , Jai Patel , Shauna Williams , Lisa Gittens-Williams , Alfred A. Lardizabal","doi":"10.1016/j.jctube.2025.100527","DOIUrl":null,"url":null,"abstract":"<div><div>Treating latent tuberculosis infection (LTBI) is a core intervention in reducing the burden of tuberculosis. Treatment for LTBI is challenging due to the many steps in the process, collectively termed the cascade of care. In pregnant patients with LTBI, these challenges are heightened due to the medical and social intricacies introduced by pregnancy. In this study, we evaluate the effectiveness of a screening intervention for LTBI in the prenatal clinic of an inner-city hospital in the United States, and analyze the cascade of care to identify areas for improvement. Of the n = 99 patients who had a positive QuantiFERON Gold Test (QFN), 96.7 % had a chest x-ray (CXR) ordered by their provider, 95.6 % completed the CXR, 82.8 % were referred to the TB clinic, 44.4 % scheduled an appointment with the TB clinic, 23.2 % attended an appointment at the TB clinic, 21.2 % started medical treatment of LTBI, and 17.2 % completed LTBI treatment. Together this data shows that majority of patients in the prenatal clinic with a positive QFN do not complete LTBI treatment. Most patients are lost during the steps that transition them from obstetric care to the care of the TB clinic. Improving the cascade of care for LTBI will require increased education of patients on the importance of treating LTBI, and improving the process that transitions patients from obstetric care to the care of the TB clinic.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100527"},"PeriodicalIF":1.9000,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cascade of care for the diagnosis and treatment of latent tuberculosis infection in an inner-city hospital prenatal clinic\",\"authors\":\"Jay Phansalkar , Rajas Karajgikar , Jai Patel , Shauna Williams , Lisa Gittens-Williams , Alfred A. Lardizabal\",\"doi\":\"10.1016/j.jctube.2025.100527\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Treating latent tuberculosis infection (LTBI) is a core intervention in reducing the burden of tuberculosis. Treatment for LTBI is challenging due to the many steps in the process, collectively termed the cascade of care. In pregnant patients with LTBI, these challenges are heightened due to the medical and social intricacies introduced by pregnancy. In this study, we evaluate the effectiveness of a screening intervention for LTBI in the prenatal clinic of an inner-city hospital in the United States, and analyze the cascade of care to identify areas for improvement. Of the n = 99 patients who had a positive QuantiFERON Gold Test (QFN), 96.7 % had a chest x-ray (CXR) ordered by their provider, 95.6 % completed the CXR, 82.8 % were referred to the TB clinic, 44.4 % scheduled an appointment with the TB clinic, 23.2 % attended an appointment at the TB clinic, 21.2 % started medical treatment of LTBI, and 17.2 % completed LTBI treatment. Together this data shows that majority of patients in the prenatal clinic with a positive QFN do not complete LTBI treatment. Most patients are lost during the steps that transition them from obstetric care to the care of the TB clinic. Improving the cascade of care for LTBI will require increased education of patients on the importance of treating LTBI, and improving the process that transitions patients from obstetric care to the care of the TB clinic.</div></div>\",\"PeriodicalId\":37942,\"journal\":{\"name\":\"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases\",\"volume\":\"39 \",\"pages\":\"Article 100527\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-04-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S240557942500018X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S240557942500018X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Cascade of care for the diagnosis and treatment of latent tuberculosis infection in an inner-city hospital prenatal clinic
Treating latent tuberculosis infection (LTBI) is a core intervention in reducing the burden of tuberculosis. Treatment for LTBI is challenging due to the many steps in the process, collectively termed the cascade of care. In pregnant patients with LTBI, these challenges are heightened due to the medical and social intricacies introduced by pregnancy. In this study, we evaluate the effectiveness of a screening intervention for LTBI in the prenatal clinic of an inner-city hospital in the United States, and analyze the cascade of care to identify areas for improvement. Of the n = 99 patients who had a positive QuantiFERON Gold Test (QFN), 96.7 % had a chest x-ray (CXR) ordered by their provider, 95.6 % completed the CXR, 82.8 % were referred to the TB clinic, 44.4 % scheduled an appointment with the TB clinic, 23.2 % attended an appointment at the TB clinic, 21.2 % started medical treatment of LTBI, and 17.2 % completed LTBI treatment. Together this data shows that majority of patients in the prenatal clinic with a positive QFN do not complete LTBI treatment. Most patients are lost during the steps that transition them from obstetric care to the care of the TB clinic. Improving the cascade of care for LTBI will require increased education of patients on the importance of treating LTBI, and improving the process that transitions patients from obstetric care to the care of the TB clinic.
期刊介绍:
Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.