The Preventing TB Overseas Pilot Study (PTOPS) : voluntary latent tuberculosis infection testing and treatment for US-bound immigrants in Vietnam

In 1989, the United States declared a goal to eliminate tuberculosis (TB) by 2010, with elimination defined as < 1 case per million. In 2019, the US reported 27 cases per million with 70% of cases occurring in the foreign-born. Over 80% of cases were reactivation of latent TB infection (LTBI) acquired prior to US arrival. Strategies to address LTBI have been suboptimal and innovations are critical to reach TB elimination. Currently, the pre-arrival immigrant medical examination focuses on identifying TB disease. To address LTBI in immigrants, a potential strategy is to offer voluntary LTBI testing using an interferon-gamma release assay (IGRA) and 3 months of weekly isoniazid and rifapentine (3HP) treatment during the examination. A prospective cohort study was conducted among US-bound immigrant visa applicants undergoing the examination in Vietnam. This study assesses uptake, acceptability, and factors associated with three different points of the LTBI care cascade. Of 5311 visa applicants recruited, 2438 (46%) consented; 2276 had an IGRA processed, and 484 (21%) tested positive. Among 452 participants eligible for 3HP, 304 (67%) initiated treatment and 268 (88%) completed treatment. Being female, aged 18-35, ... (continues)