Travel Medicine and Infectious Disease
Volume 27, 2019, Pages 39-45

Screening for active and latent tuberculosis among asylum seekers in Italy: A retrospective cohort analysis (Article)

Pontarelli A. , Marchese V. , Scolari C. , Capone S. , El-Hamad I. , Donato F. , Moioli R. , Girardi E. , Cirillo D.M. , Castelli F. , Matteelli A.*
  • a University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, Brescia, 25123, Italy
  • b University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, Brescia, 25123, Italy, Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, Negrar, 37024, Italy
  • c Unità Distretto Territoriale, ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, Brescia, 25123, Italy
  • d Unità Distretto Territoriale, ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, Brescia, 25123, Italy
  • e University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, Brescia, 25123, Italy, Unità Distretto Territoriale, ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, Brescia, 25123, Italy
  • f Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Viale Europa 11, Brescia, 25123, Italy
  • g Centro Pneumologico Preventivo, ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, Brescia, 25123, Italy
  • h Clinical Epidemiology Unit, Lazzaro Spallanzani National Institute for Infectious Diseases, Via Portuense, 292, Rome, 00149, Italy
  • i IRCCS San Raffaele Scientific Institute, Via Olgettina Milano, 60, Milan, 20132, Italy
  • j University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, Brescia, 25123, Italy
  • k University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, Brescia, 25123, Italy

Abstract

Background: The World Health Organization conditionally recommends systematic screening of tuberculosis (TB) and Latent Tuberculosis Infection (LTBI) among asylum seekers (AS) from high-burden countries, but the effectiveness of different screening approaches is controversial. Methods: We report the results of a retrospective cohort analysis of TB and LTBI screening among consecutive AS in Brescia, Italy during 2015–2016. TB screening was based on symptoms, LTBI screening on the tuberculin skin test (TST). Logistic regression analysis was performed to identify factors associated with screening uptake. Results: Of 2904 registered AS 2567 (88.4%) were evaluated for TB, 62 (2.4%) had symptoms and active TB yield was 155/100,000. Prevalence and incidence TB rates were 545/100,000 persons and 220/100,000 person-years. Questionnaire screening identified 28.6% (4/14) prevalent cases. Of 2303 (89.7%) AS with TST result, the positivity rate was 36.6% (843/2303). Of the 843 candidates for LTBI treatment 413 (49.0%) completed the screening. LTBI treatment was prescribed to 190 (47.9%) of 397 eligible individuals, 10.8% (91) completed treatment. Conclusions: TB prevalence and incidence rates were high in this AS population, but symptom-based screening performed poorly. LTBI cascade losses were significant and mainly attributable to the defragmentation of the health care system. © 2018

Author Keywords

Refugees migrant Delivery of healthcare Europe

Index Keywords

urban area refugee respiratory tract infection mass screening follow up human Refugees middle aged Cohort Studies travel interferon gamma release assay Interferon-gamma Release Tests priority journal antiviral susceptibility screening asylum seeker Young Adult Humans Adolescent diagnostic value male Treatment Outcome latent tuberculosis female tuberculosis prevalence Article Retrospective Studies tuberculin test adult isoniazid thorax radiography world health organization cohort analysis Italy retrospective study Delivery of Health Care rifampicin health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85055451547&doi=10.1016%2fj.tmaid.2018.10.015&partnerID=40&md5=6337f8c3006cf14c7b6b0d81e44c9179
DOI: 10.1016/j.tmaid.2018.10.015
ISSN: 14778939
Cited by: 2
Original Language: English