Journal of Hospital Infection
Volume 90, Issue 3, 2015, Pages 253-259

Preventing tuberculosis transmission at a maternity hospital by targeted screening radiography of migrants (Article)

Schechner V.* , Lessing J.B. , Grisaru-Soen G. , Braun T. , Abu-Hanna J. , Carmeli Y. , Aviram G.
  • a Department of Epidemiology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • b Department of Obstetrics and Gynecology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • c Department of Pediatrics, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • d Department of Epidemiology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • e Department of Epidemiology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • f Department of Epidemiology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • g Department of Radiology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Abstract

Background: Israel has been the destination of large numbers of illegal migrants from East African countries in recent years. Despite efforts to detect and treat active tuberculosis (TB) at the border, 75% of all active TB cases diagnosed in our hospital were illegal migrants. In 2012, there was a large-scale TB exposure in our maternity ward, neonatal, and paediatric intensive care units following the admission of an infectious but apparently asymptomatic migrant who was in labour. A hospital-wide screening programme was subsequently implemented to prevent exposure of patients and staff to TB. Aim: To report the results of the first year of this intervention in the maternity hospital. Methods: All illegal migrants from countries where TB is highly prevalent were screened by chest radiography (CR) upon admission to the maternity hospital. The results were immediately categorized by a radiologist as either 'suggestive of active pulmonary TB' or 'non-suggestive'. Patients with CR suggestive of TB were placed in airborne isolation and underwent further evaluation. Findings: Four hundred and thirty-one apparently asymptomatic migrant women underwent CR screening. Most (363, 84%) presented in labour. Eleven women (2.6%) had a CR suggestive of active pulmonary TB which was confirmed in three (0.7% of screened women). No TB cases were missed by the CRs. Neither patients nor hospital staff were exposed to TB. Conclusion: Targeted CR screening for TB among high-risk women upon their admission to a maternity hospital had a high yield and was an effective strategy to prevent in-hospital transmission of TB. © 2015 The Healthcare Infection Society.

Author Keywords

Screening Migrants tuberculosis Israel Radiography

Index Keywords

transmission Israel mass screening radiography predictive value human Patient Isolation statistics and numerical data controlled study Mycobacterium tuberculosis procedures Hospitals, Maternity Humans migrant maternity ward lung tuberculosis tuberculostatic agent Antitubercular Agents Infant, Newborn male Tuberculosis, Pulmonary Adolescent female tuberculosis newborn Disease Transmission, Infectious pregnancy high risk population prevalence isolation and purification prevention and control atelectasis Article disease transmission infection control antibiotic prophylaxis major clinical study adult migration isoniazid pleura effusion Predictive Value of Tests thorax radiography antibiotic sensitivity hospital Transients and Migrants miliary tuberculosis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84930572713&doi=10.1016%2fj.jhin.2015.03.008&partnerID=40&md5=a62a047c2b62e62faa2244ce69587385
DOI: 10.1016/j.jhin.2015.03.008
ISSN: 01956701
Cited by: 3
Original Language: English