TB screening is missing the majority of cases
Research has found that the current Tuberculosis (TB) screening process – which involves chest x-rays – fails to detect up to 70 per cent of cases of the infection in immigrants arriving in the UK.
It is thought that blood tests would be a more effective screening method, being able to detect 90 per cent of cases of TB.
Blood tests will be able to identify latent infections – those which are present but are inactive in the body – whereas chest x-rays can only detect active infections.
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The researchers from Imperial College London said that if dormant cases of TB are found, carriers would be able to take a course of antibiotics to prevent them developing an active form of the disease.
TB is a bacterial infection which normally stays asymptomatic in the body, meaning that it is inactive and there are no symptoms. When the disease becomes active it attacks the lungs and approximately half of sufferers die from it.
The new findings back up guidelines which were updated in March by the National Institute for Health and Clinical Excellence (NICE) on TB screening.
In Britain incidents of TB have risen dramatically in recent years and the researchers believe that this is due to a 98 per cent increase in cases of TB in people who move to Britain from overseas.
Current legislation requires the testing of all immigrants from countries which have a TB incidence higher than 40 in every 100,000 people per year.
The researchers said that when entering the country, the majority of immigrants have an inactive form of the disease, which then progresses in to the full-blown form of the illness a few years after their arrival.
Professor Ajit Lalvani, the director of TB research at Imperial College London, said: “By treating people at that early stage, we can prevent them from developing a serious illness and becoming infectious.”
“Crucially, this wider screening could substantially reduce TB incidence while remaining cost-effective. Our findings provide the missing evidence-base for the new national strategy to expand immigrant screening.”
A spokesperson from the Department of Health said: “Tuberculosis is a global problem and sustained action is needed to detect, diagnose and treat cases earlier. We are funding TB Alert, the UK's national TB charity, to increase awareness of TB among primary healthcare professionals and the public.”
“We are pleased that this research backs up the latest NICE guidance on TB screening. We expect the local NHS to consider the best ways of tackling this issue in their area.”
Introducing Dosis - the AI powered dosing platform
Cloud-based platform Dosis uses AI to help patients and clinicians tailor their medication plans. Shivrat Chhabra, CEO and co-founder, tells us how it works.
When and why was Dosis founded?
Divya, my co-founder and I founded Dosis in 2017 with the purpose of creating a personalised dosing platform. We see personalisation in so many aspects of our lives, but not in the amount of medication we receive. We came across some research at the University of Louisville that personalised the dosing of a class of drugs called ESAs that are used to treat chronic anaemia. We thought, if commercialised, this could greatly benefit the healthcare industry by introducing precision medicine to drug dosing.
The research also showed that by taking this personalised approach, less drugs were needed to achieve the same or better outcomes. That meant that patients were exposed to less medication, so there was a lower likelihood of side effects. It also meant that the cost of care was reduced.
What is the Strategic Anemia Advisor?
Dosis’s flagship product, Strategic Anemia Advisor (SAA), personalises the dosing of Erythropoiesis Stimulating Agents (ESAs). ESAs are a class of drugs used to treat chronic anaemia, a common complication of chronic kidney disease.
SAA takes into account a patient’s previous ESA doses and lab levels, determines the patient’s unique response to the drug and outputs an ESA dose recommendation to keep the patient within a specified therapeutic target range. Healthcare providers use SAA as a clinical decision support tool.
What else is Dosis working on?
In the near term, we are working on releasing a personalised dosing module for IV iron, another drug that’s used in tandem with ESAs to treat chronic anaemia. We’re also working on personalising the dosing for the three drugs used to treat Mineral Bone Disorder. We’re very excited to expand our platform to these new drugs.
What are Dosis' strategic goals for the next 2-3 years?
We strongly believe that personalised dosing will be the standard of care within the next decade, and we’re honored to be a part of making that future a reality. In the next few years, we see Dosis entering partnerships with other companies that operate within value-based care environments, where tools like ours that help reduce cost while maintaining or improving outcomes are extremely useful.
What do you think AI's greatest benefits to healthcare are?
If designed well, AI in healthcare allows for a practical and usable way to deploy solutions that would not be feasible otherwise. For example, it’s possible for someone to manually solve the mathematical equations necessary to personalise drug dosing, but it is just not practical. AI in healthcare offers an exciting path forward for implementing solutions that for so long have appeared impractical or impossible.