Infectious Disease Reports
Volume 8, Issue 2, 2016, Pages 50-56

Active tuberculosis case finding interventions among immigrants, refugees and asylum seekers in Italy (Article) (Open Access)

Schepisi M.S.* , Gualano G. , Piselli P. , Mazza M. , D'Angelo D. , Fasciani F. , Barbieri A. , Rocca G. , Gnolfo F. , Olivani P. , Ferrarese M. , Codecasa L.R. , Palmieri F. , Girardi E.
  • a Clinical Epidemiology Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases L. Spallanzani, Rome, Italy
  • b Respiratory Infectious Diseases Unit, Department of Clinical Research, National Institute for Infectious Diseases, L. Spallanzani, Rome, Italy
  • c Clinical Epidemiology Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases L. Spallanzani, Rome, Italy
  • d Cittadini del mondo, Rome, Italy
  • e Cittadini del mondo, Rome, Italy
  • f Medici per i Diritti Umani Onlus, Rome, Italy
  • g Medici per i Diritti Umani Onlus, Rome, Italy
  • h Salute per i migranti forzati (SaMiFo) Centro Astalli, Local Health Unit AUSL RM A, Rome, Italy
  • i Salute per i migranti forzati (SaMiFo) Centro Astalli, Local Health Unit AUSL RM A, Rome, Italy
  • j NAGA, Milan, Italy
  • k Regional Reference Center for TB -Villa Marelli Institute, Niguarda Ca' Granda Hospital, Milan, Italy
  • l Regional Reference Center for TB -Villa Marelli Institute, Niguarda Ca' Granda Hospital, Milan, Italy
  • m Respiratory Infectious Diseases Unit, Department of Clinical Research, National Institute for Infectious Diseases, L. Spallanzani, Rome, Italy
  • n Clinical Epidemiology Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases L. Spallanzani, Rome, Italy

Abstract

In Italy tuberculosis (TB) is largely concentrated in vulnerable groups such as migrants and in urban settings. We analyzed three TB case finding interventions conducted at primary centers and mobile clinics for regular/ irregular immigrants and refugees/asylum seekers performed over a four-year period (November 2009-March 2014) at five different sites in Rome and one site in Milan, Italy. TB history and presence of symptoms suggestive of active TB were investigated by verbal screening through a structured questionnaire in migrants presenting for any medical condition to out-patient and mobile clinics. Individuals reporting TB history or symptoms were referred to a TB clinic for diagnostic workup. Among 6347 migrants enrolled, 891 (14.0%) reported TB history or symptoms suggestive of active TB and 546 (61.3%) were referred to the TB clinic. Of them, 254 (46.5%) did not present for diagnostic evaluation. TB was diagnosed in 11 individuals representing 0.17% of those screened and 3.76% of those evaluated. The overall yield of this intervention was in the range reported for other TB screening programs for migrants, although we recorded an unsatisfactory adherence to diagnostic workup. Possible advantages of this intervention include low cost and reduced burden of medical procedures for the screened population. © M.S. Schepisi et al., 2016.

Author Keywords

Migrants tuberculosis Active case finding Adherence to screening Access to care

Index Keywords

controlled study tuberculosis control immigrant Italy outpatient clinical article hospital symptom structured questionnaire screening diagnosis asylum seeker human
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84992756753&doi=10.4081%2fidr.2016.6594&partnerID=40&md5=4da90c477110cf5389c702f56331f43b
DOI: 10.4081/idr.2016.6594
ISSN: 20367449
Cited by: 11
Original Language: English