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Introduction Rates of Tuberculosis (TB) in England remain comparatively high. About 72% of TB cases in the UK occur among non-UK born individuals, mostly as a result of reactivation of latent TB infection (LTBI). Programmatic screening for LTBI is a key intervention of the TB strategy for England. This paper aims to review the evidence of a long-standing LTBI screening initiative to shape and inform policy around LTBI screening. Methods A retrospective cohort was created through probabilistic linkage between LTBI screening data and TB case data from the Enhanced TB surveillance system in the UK. Persons screened for LTBI in Blackburn were followed up until they died, became a case, imputed emigration date or cohort end date (end of 2014). Incidence rates (IR) and incidence rate rations (IRRs) of TB were calculated in single and multi variable (Poisson regression) analysis. Results In total, 21 of the 1,341 individuals screened with QuantiFERON (QFT) between 2009 and 2013 and 76 of 479 screened with Tuberculin skin test (TST) between 1989-2001 were reported with active TB. Crude IRs amongst LTBI positive, treatment naive individuals were 4,900 per 100,000 person years (py) and 2,297 per 100,000 py in the QFT and TST cohorts respectively. Poisson regression showed that LTBI positivity (IRR 27.0, CI 8.5- 86.2) and no chemoprophylaxis (IRR 0.14, CI 0.04-0.5) were associated with becoming a case of TB. Conclusions Our observational study showed high TB rates among treatment naive individuals and a strong association between LTBI positivity and treatment and TB case notification. Demonstrating feasibility and effectiveness of LTBI screening, important policy lessons can be drawn for national LTBI screening in England and beyond.

Introduction: HIV infected persons are more susceptible to becoming infected with TB. India has the highest TB burden in the world and accounts for 23% of the global incidence of TB cases. The prevalence of Tb/HIV coinfection is 5%. This paper aims to find prevalence of coinfection in Chandigarh. Further, the various outcomes of TB treatment in coinfected patients are compared with those among non-HIV-infected TB patients registered under RNTCP. Method: A retrospective cohort study was conducted in April 2012-March 2014. Data collection was done from the ART Centre and the Designated Microscopy Centres (DMCs) under RNTCP. The total number of PLHIVs on active ART (212) and the new TB Cases (Pul & EP) taking treatment from the DMCs (3551) were taken. Patients were followed and treatment outcome among HIV –TB coinfected patients was compared with only TB patients. Results: Out of total patients taking DOTS (3551), 2.5%(88) were HIV positive. Out of 212 HIV positive patients, 17.4% (37) had tuberculosis. Cure rate (70%) was more among the HIV negative population as compared to the coinfected patients (21.6%). Rate of treatment completion was 63.6% among the HIV positive patients. Prevalence of MDR-TB was 1.1% among the coinfected and 3.8% among the HIV negative TB patients. 8% of the coinfected patients died during the course of their treatment as compared to 2.6% among the HIV negative TB patients. Conclusion: Compared to those with TB only, co-infected patients showed better TB treatment success rates and lower rates of treatment default and failure. Death rate among the coinfected patients was almost double than that in the only TB patients.