Israel Medical Association Journal
Volume 17, Issue 1, 2015, Pages 11-13

The yield of tuberculosis screening of undocumented migrants from the Horn of Africa based on chest radiography (Article)

Mor Z.* , Weinstein O. , Tischler-Aurkin D. , Leventhal A. , Alon Y. , Grotto I.
  • a Department for Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel, Ramla Department of Health, Ramla, Israel
  • b Southern District Medical Facility, Medical Corps, Israeli Defense Forces, Israel
  • c Israeli Prison Service, Ramla, Israel
  • d Department of International Relations, Ministry of Health, Jerusalem, Israel, Braun School of Public Health, Hebrew University, Jerusalem, Israel
  • e Saharonim Prison, Ktziot, Israel
  • f Public Health Services, Jerusalem, Israel, Department of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel

Abstract

Background: Since 2006 more than 60,000 migrants arrived in Israel from the Horn of Africa (HoA: Sudan, Eritrea, Ethiopia). They were detained in prison and screened for tuberculosis (TB) by means of an interview and chest X-ray (CXR).Objectives: To evaluate the yield of this screening process.Methods: This cross-sectional study evaluated the validity of CXR in a random sample of 1087 of the 5335 HoA migrants (20.4%) who arrived in 2009, and assessed its related costs.Results: Sixty-two migrants (5.7%) had CXRs with TBsuspicious findings, and 11 of them were finally diagnosed with TB (17.7% of all TB-suspicious CXRs). TB point-prevalence was 1000 cases per 100,000 migrants (1.0%). As no additional TB cases were diagnosed on arrival, CXR sensitivity, specificity and positive predictive value were 100%, 96.1% and 17.7%, respectively. The interview did not contribute to the detection of migrants with TB. Direct costs related to the detection of single TB cases in prison was 17,970 shekels (US$ 4585), lower than the treating cost of 28,745 shekels ($ 7335). During 2008–2010, 88 HoA migrants who had been screened at the prison after crossing the border were later diagnosed with TB in the community. The average annual TB incidence was 132 cases/100,000 migrants. We traced 56 (63.6%) of the CXRs that were performed during detention. Of those, 41 (73.2%) were unremarkable, 8 (14.2%) were TB suspicious and 7 (12.5%) had non-TB-related abnormalities.Conclusions: CXR-based screening is a valid and cost-saving tool for screening HoA migrants for TB; the interview has significant limitations. © 2015 Israel Medical Association. All rights reserved.

Author Keywords

Screening Horn of Africa (HoA) Israel Tuberculosis (TB) Chest X-ray (CXR) Immigration

Index Keywords

Eritrea Israel Human immunodeficiency virus infection mass screening predictive value follow up human validation study middle aged prisoner statistics and numerical data Prisoners screening test ethnology procedures Cross-Sectional Studies interview Young Adult cross-sectional study migrant Humans Adolescent male female tuberculosis Africa questionnaire prevalence sensitivity and specificity Incidence Article Ethiopia adult migration Predictive Value of Tests thorax radiography Transients and Migrants Radiography, Thoracic mixed infection Sudan
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84921862824&partnerID=40&md5=babed0183e28104987cd3b944b386868
ISSN: 15651088
Cited by: 9
Original Language: English