BMC Public Health
Volume 12, Issue 1, 2012

Community health workers improve contact tracing among immigrants with tuberculosis in Barcelona (Article)

Ospina J.E.* , Orcau A. , Millet J.-P. , Sánchez F. , Casals M. , Caylà J.A.
  • a Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps 1, 08023 Barcelona, Spain, Departament de Pediatria, Ginecologia i Medicina Preventiva, Universitat Autònoma de Barcelona (UAB), Plaza Cívica-Campus de la UAB, 08193 Bellaterra, Spain
  • b Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps 1, 08023 Barcelona, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), C/Melchor Fernández Almagro 3-5, 28029, Madrid, Spain
  • c Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps 1, 08023 Barcelona, Spain, Departament de Pediatria, Ginecologia i Medicina Preventiva, Universitat Autònoma de Barcelona (UAB), Plaza Cívica-Campus de la UAB, 08193 Bellaterra, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), C/Melchor Fernández Almagro 3-5, 28029, Madrid, Spain
  • d Servicios de Medicina Interna, Enfermedades Infecciosas y Microbiología, Hospital Del Mar Barcelona, Paseo Marítimo 25-29, 08003 Barcelona, Spain
  • e Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps 1, 08023 Barcelona, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), C/Melchor Fernández Almagro 3-5, 28029, Madrid, Spain, Departament de Salut Pública, Universitat de Barcelona, Gran Via de les Corts Catalanes, 585, 08007 Barcelona, Spain, Departament de Ciencies Basiques, Universitat Internacional de Catalunya, Josep Trueta s/n, 08195 Sant Cugat del Vallés, Spain
  • f Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps 1, 08023 Barcelona, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), C/Melchor Fernández Almagro 3-5, 28029, Madrid, Spain

Abstract

Background. The important increase in immigration during recent years has changed the epidemiology and control strategies for tuberculosis (TB) in many places. This study evaluates the effectiveness of intervention with community health workers (CHW) to improve contact tracing among immigrants. Methods. The study included all TB cases detected by the Barcelona TB Program from 2000 to 2005 and compared a period without CHW intervention (2000-2002) to a period with CHW intervention (2003-2005). The influence on contact tracing of sex, age, hospital of diagnosis, district of residence, birthplace, HIV, homeless and CHW intervention was analysed by logistic regression. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. Results. 960 foreign born TB cases were detected, 388 in the intervention period. Contact tracing was performed on 65,7% of 201 smear-positive cases during the pre-intervention period compared to 81.6% of 152 smear-positive TB cases during the intervention period (p < 0.001). Risk factors associated with incomplete contact tracing of smear-positive index cases included being diagnosed in two hospitals without contact tracing TB unit (OR = 3.5; CI:1.4-8.9) and (OR = 4.6; CI:1.6-13.5) respectively, birth place in India-Pakistan (OR = 4.4; CI:1.9-10.3) or North Africa (OR = 4.3; CI:1.8-10.5), having an unknown residence (OR = 5.4; CI:1.6-18.0), being HIV-infected (OR = 6.1; CI:2.5-14.8) or homeless (OR = 3.3; CI:1.3-8.2), and the absence of CHW intervention (OR = 2.4; CI:1.3-4.3). Conclusions. The effectiveness of contact tracing for TB control in areas with high immigration can be improved by incorporating CHWs who act as translators, cultural mediators and facilitators who accompany cases and contacts through treatment and follow-up. © 2012 Ospina et al; licensee BioMed Central Ltd.

Author Keywords

[No Keywords available]

Index Keywords

Community Health Workers professional standard human middle aged comparative study health auxiliary Professional Role Young Adult Humans lung tuberculosis Adolescent male Emigrants and Immigrants Tuberculosis, Pulmonary preschool child Spain Infant Child, Preschool Multivariate Analysis female contact examination Contact Tracing Article disease transmission adult migration Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84857778977&doi=10.1186%2f1471-2458-12-15822394990&partnerID=40&md5=3df12964ce45646adc8242a089d8cc32
DOI: 10.1186/1471-2458-12-15822394990
ISSN: 14712458
Cited by: 23
Original Language: English