Our Group organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.
Background: Patients with severe Inflammatory Bowel Disease (IBD) are prescribed anti-TNF-�± agents, if clinical need necessitates,
whose immunosuppressive action can potentially reactivate latent tuberculosis infections (LTBI). Meticulous pre anti-TNF-�± LTBI
screening and management in accordance with the British Thoracic Society�s (BTS) Guidelines is imperative for patient safety and
public health.
Objective: A retrospective clinical audit was performed to evaluate the performance of University Hospital Southampton�s
Gastroenterology department in screening for LTBI in patients with IBD. The performance of LTBI screening was compared to the
BTS standards.
Method: The audit population was obtained using the gastroenterology department�s biologics database. Inclusion criteria included
patients who started their first anti-TNF-�± agent between 01/01/2006 to 04/11/2016. Exclusion criteria included deceased patients
and patients screened by alternative departments/trusts. Extent of LTBI screening was assessed using hospital record systems: EDocs,
EQuest, ECamis and Spectra PACS. If evidence of screening was not located, then this was considered as a failure to meet standard.
Following statistical analysis, comparisons were made with BTS standards.
Results: Of the 471 patients audited, 51.2% were females and 48.8% males. 75.2% were CD patients and 24.8% were UC patients. 231
patients� (49%) LTBI screening was insufficient. 157 patients (33.3%) lacked an adequate TB history and 94 patients (20%) failed to
have a chest radiograph (CXR) within three months of therapy commencement. Additionally, 85 patients (18.3%) failed to have an
IGRA performed. 15 patients (3.2%) were diagnosed with LTBI, while one case of TB reactivation occurred once immunosuppressive
therapy had commenced.
Conclusion: The completeness of LTBI screening in the audited group was suboptimal with deficits in TB history performance, CXR,
TST and IGRAs. One case of active miliary TB occurred as a result of inadequate screening. In light of this, recommendations to
address deficits and ultimately improve screening were proposed.
Biography
Shuaib Meghji is currently studying at University Hospital Southampton, UK.