International Health
Volume 8, Issue 5, 2016, Pages 324-329

Lessons learnt from TB screening in closed immigration centres in Italy (Article) (Open Access)

Crepet A.* , Repetto E. , Al Rousan A. , Schepisi M.S. , Girardi E. , Prestileo T. , Codecasa L. , Garelli S. , Corrao S. , Ippolito G. , Decroo T. , Maccagno B.
  • a Médecins Sans Frontières, Operational Centre Brussels, Italian Mission, Italy
  • b Médecins Sans Frontières, Operational Centre Brussels, Italian Mission, Italy
  • c Médecins Sans Frontières, Operational Centre Brussels, Italian Mission, Italy
  • d Department of Epidemiology, National Institute for Infectious Diseases L. Spallanzani, IRCCS Rom, Italy
  • e Department of Epidemiology, National Institute for Infectious Diseases L. Spallanzani, IRCCS Rom, Italy
  • f Department of Infectious Diseases, ARNAS, Ospedale Civico-Benfratelli, Palermo, Italy
  • g Villa Marelli Institute, Niguarda Ca' Granda Hospital, Milan, Italy
  • h Médecins Sans Frontières, Operational Centre Brussels, Italian Mission, Italy
  • i Department of Infectious Diseases, ARNAS, Ospedale Civico-Benfratelli, Palermo, Italy, Centre of Research for Effectiveness and Appropriateness in Medicine, Palermo, Italy, Biomedical Department of Internal Medicine and Subspecialties, University of Palermo, Italy
  • j Department of Epidemiology, National Institute for Infectious Diseases L. Spallanzani, IRCCS Rom, Italy
  • k Médecins Sans Frontières, Operational Centre Brussels, Operational Research Unit, Italy
  • l Médecins Sans Frontières, Operational Centre Brussels, Italian Mission, Italy

Abstract

Background: Between June 2012 and December 2013 Médecins Sans Frontières launched a pilot project with the aim of testing a strategy for improving timely diagnosis of active pulmonary TB among migrants hosted in four centres of identification and expulsion (CIE) in Italy. Methods: This is a descriptive study. For active TB case finding we used an active symptom screening approach among migrants at admission in four CIE's. Here we describe the feasibility and the yield of this programme. Results: Overall, 3588 migrants were screened, among whom 87 (2.4%) had a positive questionnaire. Out of 30 migrants referred for further investigations, three were diagnosed as having TB, or 0.1% out of 3588 individuals that underwent screening. Twenty-five (29%, 25/87) migrants with positive questionnaires were not referred for further investigation, following the doctors" decision; however, for 32 (37%, 32/87) migrants the diagnostic work-out was not completed. In multivariate analyses, being over 35 years (OR 1.7; 95% CI 1.12.6) and being transgender (OR 4.9; 95% CI 2.1-11.7), was associated with a positive questionnaire. Conclusions: TB screening with symptom screening questionnaires of migrants at admission in closed centres is feasible. However, to improve the yield, follow-up of patients with symptoms or signs suggestive for TB needs to be improved. © The Author 2016.

Author Keywords

Screening Migrants Italy tuberculosis Questionnaire Immigration detention centres

Index Keywords

descriptive research hospital admission refugee multicenter study mass screening clinical trial human immigration Refugees middle aged statistics and numerical data priority journal Aged Surveys and Questionnaires Young Adult health program Humans migrant lung tuberculosis Adolescent male transgender Tuberculosis, Pulmonary female Aged, 80 and over patient referral very elderly pilot study questionnaire diagnostic test symptom Article feasibility study organization and management major clinical study adult migration Emigration and Immigration Italy medical decision making Transients and Migrants case finding Pilot Projects
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84995780900&doi=10.1093%2finthealth%2fihw025&partnerID=40&md5=0fdb610908f7881a1ced7bf541e581d6
DOI: 10.1093/inthealth/ihw025
ISSN: 18763413
Cited by: 9
Original Language: English