Critical Thinking Latent Tuberculosis Question and Answer 2022

Running head: CRITICAL THINKING: LATENT TUBERCULOSIS
CRITICAL THINKING: LATENT TUBERCULOSIS
Name of the Student:
Name of the University:
Author note:

CRITICAL THINKING: LATENT TUBERCULOSIS1
Question a
The main question which Usdin et al. (2017), were attempting to answer in their study is
the effectiveness and feasibility of a program delivering screening interventions for latent
tuberculosis infection (LTBI) among newly migrated students who were attending language
classes within a community college.
Question b
It has been evidenced by Usdin et al. (2017) that the incidence of reporting and attending
LTBI screening programs implemented across primary care settings within the United Kingdom
are likely to be low across individuals who have immigrated to the nation recently. There is thus
a need to implement LTBI programs across settings such as community-based environments,
which most immigrants can attend. Thus, to ensure the development of future LTBI screening
programs across more accessible environments, it was necessary to answer this question.
Question c
A cohort study is particularly useful to determine the temporal sequence between an
outcome and an exposure over time considering that participants are generally free from disease
at baseline. This further makes it easier to compare the outcomes observed between specific
participants who have been exposed and not been exposed (Þórarinsdóttir et al. 2019). In the
study by Usdin et al. (2017), a cohort design was appropriate since it helped to compare between
screening outcomes across participants without LTBI and treatment outcomes for LTBI positive
participants.

CRITICAL THINKING: LATENT TUBERCULOSIS2
Migrant students belonging to countries with high LTBI incidence were recruited based
on observational data, were engaged in educational sessions on TB management. This was
followed by screening using a single-step interferon-gamma release assay (IGRA). Positive
testing students then attended the 3 month treatment program Birmingham Chest Clinic,
comprising of 600 mg rifampicin and 300 mg isoniazid. They were evaluated for treatment
completion, prophylaxis and attendance (Usdin et al. 2017).
Question d
From Table 1 of Usdin et al. (2017), it can be observed that the sample of 440
participants were aged 15 to 35 years, comprised of both females and males, had migrated to the
UK within 5 years of more and were from countries with LTBI incidence ranging from more
than 40 to more than 200/100, 000 incidences. This descriptive epidemiology is relevant since it
reflects the target population outlined in the research question – that of migrants from high
incidence countries. However, inclusion of only individuals who have migrated within 5 years
would have been appropriate since the research aimed to address LTBI program efficiency
across new UK migrants. This epidemiology can only be generalized to countries with high
LTBI rates considering the incidence rate criteria described in Table 1.
Question e
Treatment and follow up was evaluated to assess treatment compliance, completion and
effectiveness across positive tested migrants. The cost savings were likely underestimated due to
the small sample size of only 71 treated migrants, which may not reflect the much larger
population. There is thus needed to conduct research specifically on larger migrant samples,
already having LTBI for a more valid cost-effectiveness determination (Usdin et al. 2017).