CATAPULT Trial Shows Treatment of Latent TB in Migrants Within Primary Care Safe and Effective
26 November 2024
A recent study published in the European Respiratory Journal by researchers at Queen Mary University of London, Barts Health NHS Trust and in close collaboration with Newham Integrated Care Board has shown that the treatment of latent tuberculosis infection in recent migrants to the UK can be safely and effectively managed within primary care when compared to specialist secondary care services at lower cost.
The study confirms that an award winning transformative primary care service in Newham, East London, could change how patients may be offered care at more convenient times closer to where they live and at lower cost with no impact on safety.
The findings of this study have the potential to influence public health policy globally and change how and where patients are offered their care.
The research, funded by Barts Charity and supported by NIHR, was conducted by Dr Matthew Burman, Honorary Research Fellow at Queen Mary and Respiratory Consultant at Homerton Healthcare NHS Foundation Trust, and Dr Heinke Kunst, Reader in Respiratory Medicine at Queen Mary and Honorary Consultant in Respiratory Medicine at Barts Health. Other key collaborators at Queen Mary included Professor Adrian Martineau, Professor of Respiratory Infection, Professor Chris Griffiths, Professor in Primary Care, and Dr Dominik Zenner, Reader in Clinical Reader in Infectious Disease Epidemiology.
Latent tuberculosis infection is a common condition globally. It’s a condition where a person has been infected with the TB bacteria but does not have an active infection. In around one in 10 of these cases, the person infected will in future develop active TB, which may be contagious. It is estimated that one in four people in the world may have it.
The management of latent TB infection in recent migrants is a key component of the UK’s national TB strategy, and a key component of TB control policy in other high income, low TB incidence countries to reduce rates of active TB. Within the UK there are roughly 5,000 cases of active TB every year. Treating latent TB infection can prevent patients developing active TB in the future.
TB is traditionally managed in specialist services in secondary care, in specialist clinics. Newham Integrated Care Board (formerly Newham Clinical Commissioning Group) established the first service to offer testing and treatment entirely in the community by GPs and community pharmacists. This offers care closer to a patient’s home and at more convenient times, for example on weekends and outside normal office hours.
The study also found that latent TB infection treatment acceptance was lower in primary care settings compared to secondary care settings. The team are conducting further work to understand reasons for this and how to address the lower acceptance.
Further information
Research paper: ‘Treatment of latent tuberculosis infection in migrants in primary care versus secondary care’.
The CATAPULT trial (Completion and Acceptability of Treatment Across Primary Care and the commUnity for Latent Tuberculosis) compliments existing TB research at Queen Mary. Dr Kunst has conducted an NIHR-funded study on evaluating uptake of latent TB infection screening in migrants (Uptake, effectiveness and acceptability of routine screening of pregnant migrants for latent tuberculosis infection in antenatal care) and Professor Adrian Martineau leads a TB research programme to develop a new diagnostic test for latent TB infection.
Source: Queen Mary University of London
