Prevalence estimates of tuberculosis infection in adults in Denmark: a retrospective nationwide register-based cross-sectional study, 2010 to 2018

Anne Ahrens Østergaard; Troels Lillebaek; Inge Petersen; Andreas Fløe; Eliza H. Worren Bøkan; Ole Hilberg; Inge K. Holden; Lone Larsen; Ada Colic; Christian Wejse; Pernille Ravn; Bente Mertz Nørgård; Stephanie Bjerrum; Isik Somuncu Johansen

doi:10.2807/1560-7917.ES.2024.29.12.2300590

Prevalence estimates of tuberculosis infection in adults in Denmark: a retrospective nationwide register-based cross-sectional study, 2010 to 2018

Anne Ahrens Østergaard^*, Troels Lillebaek, Inge Petersen, Andreas Fløe, Eliza H. Worren Bøkan, Ole Hilberg, Inge K. Holden, Lone Larsen, Ada Colic, Christian Wejse, Pernille Ravn, Bente Mertz Nørgård, Stephanie Bjerrum, Isik Somuncu Johansen

^*Corresponding author af dette arbejde

Afdeling for Global Sundhed

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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Abstract

What did you want to address in this study and why?

We wanted to estimate the prevalence of tuberculosis infection in people aged between 15 and 64 years in Denmark. Tuberculosis infection refers to infection with Mycobacterium tuberculosis without disease. Tuberculosis is a disease that can be eliminated and the World Health Organization aims to achieve this by 2035. To accomplish this goal, it is necessary to identify and treat people with tuberculosis infection, since they represent a potential reservoir of tuberculosis.

What have we learnt from this study?

The prevalence of tuberculosis infection in adolescents and adults Denmark is 3.2%, corresponding to ca 200,000 people infected with the tuberculosis bacterium. This suggests a reservoir of 10,000 to 20,000 potential tuberculosis cases in the future. The prevalence of tuberculosis infection increases with age and the incidence rate in the country of birth.

What are the implications of your findings for public health?

Systematic screening for tuberculosis infection and preventive treatment should be implemented for people with immunosuppression or from countries with a tuberculosis incidence rate greater than 10 per 100,000 population.

Originalsprog	Engelsk
Artikelnummer	2300590
Tidsskrift	Eurosurveillance
Vol/bind	29
Udgave nummer	12
Antal sider	8
ISSN	1025-496X
DOI	https://doi.org/10.2807/1560-7917.ES.2024.29.12.2300590
Status	Udgivet - 2024

Bibliografisk note

Funding Information:
The Region of Southern Denmark and the University of Southern Denmark funded the project with a salary of AAØ. The sponsors did not influence the study design, analysis, or conclusion.

Publisher Copyright:
© 2024 European Centre for Disease Prevention and Control (ECDC). All rights reserved.

Adgang til dokumentet

10.2807/1560-7917.ES.2024.29.12.2300590Licens: CC BY

FulltextForlagets udgivne version, 263 KBLicens: CC BY

Citationsformater

Østergaard, A. A., Lillebaek, T., Petersen, I., Fløe, A., Worren Bøkan, E. H., Hilberg, O., Holden, I. K., Larsen, L., Colic, A., Wejse, C., Ravn, P., Nørgård, B. M., Bjerrum, S., & Johansen, I. S. (2024). Prevalence estimates of tuberculosis infection in adults in Denmark: a retrospective nationwide register-based cross-sectional study, 2010 to 2018. Eurosurveillance, 29(12), [2300590]. https://doi.org/10.2807/1560-7917.ES.2024.29.12.2300590

Prevalence estimates of tuberculosis infection in adults in Denmark : a retrospective nationwide register-based cross-sectional study, 2010 to 2018. / Østergaard, Anne Ahrens; Lillebaek, Troels; Petersen, Inge; Fløe, Andreas; Worren Bøkan, Eliza H.; Hilberg, Ole; Holden, Inge K.; Larsen, Lone; Colic, Ada; Wejse, Christian; Ravn, Pernille; Nørgård, Bente Mertz; Bjerrum, Stephanie; Johansen, Isik Somuncu.

I: Eurosurveillance, Bind 29, Nr. 12, 2300590, 2024.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Østergaard, AA, Lillebaek, T, Petersen, I, Fløe, A, Worren Bøkan, EH, Hilberg, O, Holden, IK, Larsen, L, Colic, A, Wejse, C, Ravn, P, Nørgård, BM, Bjerrum, S & Johansen, IS 2024, 'Prevalence estimates of tuberculosis infection in adults in Denmark: a retrospective nationwide register-based cross-sectional study, 2010 to 2018', Eurosurveillance, bind 29, nr. 12, 2300590. https://doi.org/10.2807/1560-7917.ES.2024.29.12.2300590

Østergaard, Anne Ahrens ; Lillebaek, Troels ; Petersen, Inge ; Fløe, Andreas ; Worren Bøkan, Eliza H. ; Hilberg, Ole ; Holden, Inge K. ; Larsen, Lone ; Colic, Ada ; Wejse, Christian ; Ravn, Pernille ; Nørgård, Bente Mertz ; Bjerrum, Stephanie ; Johansen, Isik Somuncu. / Prevalence estimates of tuberculosis infection in adults in Denmark : a retrospective nationwide register-based cross-sectional study, 2010 to 2018. I: Eurosurveillance. 2024 ; Bind 29, Nr. 12.

@article{39970ed2ed744f1f8cb92699f4fcce48,

title = "Prevalence estimates of tuberculosis infection in adults in Denmark: a retrospective nationwide register-based cross-sectional study, 2010 to 2018",

abstract = "Background: Tuberculosis (TB) elimination requires identifying and treating persons with TB infection (TBI). Aim: We estimate the prevalence of positive interferon gamma release assay (IGRA) tests (including TB) and TBI (excluding TB) in Denmark based on TBI screening data from patients with inflammatory bowel disease (IBD) or inflammatory rheumatic disease (IRD). Methods: Using nationwide Danish registries, we included all patients with IBD or IRD with an IGRA test performed between 2010 and 2018. We estimated the prevalence of TBI and positive IGRA with 95% confidence intervals (CI) in adolescents and adults aged 15–64 years after sample weighting adjusting for distortions in the sample from the background population of Denmark for sex, age group and TB incidence rates (IR) in country of birth. Results: In 13,574 patients with IBD or IRD, 12,892 IGRA tests (95.0%) were negative, 461 (3.4%) were positive and 221 (1.6%) were indeterminate, resulting in a weighted TBI prevalence of 3.2% (95% CI: 2.9–3.5) and weighted positive IGRA prevalence of 3.8% (95% CI: 3.5–4.2) among adults aged 15–64 years in the background population of Denmark. Unweighted TBI prevalence increased with age and birthplace in countries with a TB IR higher than 10/100,000 population. Conclusion: Estimated TBI prevalence is low in Denmark. We estimate that 200,000 persons have TBI and thus are at risk of developing TB. Screening for TBI and preventive treatment, especially in persons born in high TB incidence countries or immunosuppressed, are crucial to reduce the risk of and eliminate TB.",

author = "{\O}stergaard, {Anne Ahrens} and Troels Lillebaek and Inge Petersen and Andreas Fl{\o}e and {Worren B{\o}kan}, {Eliza H.} and Ole Hilberg and Holden, {Inge K.} and Lone Larsen and Ada Colic and Christian Wejse and Pernille Ravn and N{\o}rg{\aa}rd, {Bente Mertz} and Stephanie Bjerrum and Johansen, {Isik Somuncu}",

year = "2024",

doi = "10.2807/1560-7917.ES.2024.29.12.2300590",

language = "English",

volume = "29",

journal = "Eurosurveillance",

issn = "1025-496X",

publisher = "Centre Europeen pour la Surveillance Epidemiologique du SIDA",

number = "12",

}

TY - JOUR

T1 - Prevalence estimates of tuberculosis infection in adults in Denmark

T2 - a retrospective nationwide register-based cross-sectional study, 2010 to 2018

AU - Østergaard, Anne Ahrens

AU - Lillebaek, Troels

AU - Petersen, Inge

AU - Fløe, Andreas

AU - Worren Bøkan, Eliza H.

AU - Hilberg, Ole

AU - Holden, Inge K.

AU - Larsen, Lone

AU - Colic, Ada

AU - Wejse, Christian

AU - Ravn, Pernille

AU - Nørgård, Bente Mertz

AU - Bjerrum, Stephanie

AU - Johansen, Isik Somuncu

PY - 2024

Y1 - 2024

N2 - Background: Tuberculosis (TB) elimination requires identifying and treating persons with TB infection (TBI). Aim: We estimate the prevalence of positive interferon gamma release assay (IGRA) tests (including TB) and TBI (excluding TB) in Denmark based on TBI screening data from patients with inflammatory bowel disease (IBD) or inflammatory rheumatic disease (IRD). Methods: Using nationwide Danish registries, we included all patients with IBD or IRD with an IGRA test performed between 2010 and 2018. We estimated the prevalence of TBI and positive IGRA with 95% confidence intervals (CI) in adolescents and adults aged 15–64 years after sample weighting adjusting for distortions in the sample from the background population of Denmark for sex, age group and TB incidence rates (IR) in country of birth. Results: In 13,574 patients with IBD or IRD, 12,892 IGRA tests (95.0%) were negative, 461 (3.4%) were positive and 221 (1.6%) were indeterminate, resulting in a weighted TBI prevalence of 3.2% (95% CI: 2.9–3.5) and weighted positive IGRA prevalence of 3.8% (95% CI: 3.5–4.2) among adults aged 15–64 years in the background population of Denmark. Unweighted TBI prevalence increased with age and birthplace in countries with a TB IR higher than 10/100,000 population. Conclusion: Estimated TBI prevalence is low in Denmark. We estimate that 200,000 persons have TBI and thus are at risk of developing TB. Screening for TBI and preventive treatment, especially in persons born in high TB incidence countries or immunosuppressed, are crucial to reduce the risk of and eliminate TB.

AB - Background: Tuberculosis (TB) elimination requires identifying and treating persons with TB infection (TBI). Aim: We estimate the prevalence of positive interferon gamma release assay (IGRA) tests (including TB) and TBI (excluding TB) in Denmark based on TBI screening data from patients with inflammatory bowel disease (IBD) or inflammatory rheumatic disease (IRD). Methods: Using nationwide Danish registries, we included all patients with IBD or IRD with an IGRA test performed between 2010 and 2018. We estimated the prevalence of TBI and positive IGRA with 95% confidence intervals (CI) in adolescents and adults aged 15–64 years after sample weighting adjusting for distortions in the sample from the background population of Denmark for sex, age group and TB incidence rates (IR) in country of birth. Results: In 13,574 patients with IBD or IRD, 12,892 IGRA tests (95.0%) were negative, 461 (3.4%) were positive and 221 (1.6%) were indeterminate, resulting in a weighted TBI prevalence of 3.2% (95% CI: 2.9–3.5) and weighted positive IGRA prevalence of 3.8% (95% CI: 3.5–4.2) among adults aged 15–64 years in the background population of Denmark. Unweighted TBI prevalence increased with age and birthplace in countries with a TB IR higher than 10/100,000 population. Conclusion: Estimated TBI prevalence is low in Denmark. We estimate that 200,000 persons have TBI and thus are at risk of developing TB. Screening for TBI and preventive treatment, especially in persons born in high TB incidence countries or immunosuppressed, are crucial to reduce the risk of and eliminate TB.

U2 - 10.2807/1560-7917.ES.2024.29.12.2300590

DO - 10.2807/1560-7917.ES.2024.29.12.2300590

M3 - Journal article

C2 - 38516789

AN - SCOPUS:85188302641

VL - 29

JO - Eurosurveillance

JF - Eurosurveillance

SN - 1025-496X

IS - 12

M1 - 2300590

ER -