Scandinavian Journal of Public Health
Volume 38, Issue 3, 2010, Pages 275-282

Screening and treatment of latent tuberculosis in a cohort of asylum seekers in Norway (Article)

Harstad I.* , Jacobsen G.W. , Heldal E. , Winje B.A. , Steinshamn S.L. , Garåsen H.
  • a Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
  • b Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
  • c Norwegian Institute of Public Health, Oslo, Norway
  • d Norwegian Institute of Public Health, Oslo, Norway
  • e Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Department of Pulmonary Medicine, St Olavs University Hospital, Trondheim, Norway
  • f Department of Public Health and General Practice, Norwegian University of Science and Technology, Department of Health and Social Welfare, Trondheim, Norway

Abstract

Aims: Asylum seekers are screened for tuberculosis at entry to Norway. We aimed to assess follow-up of screening results at different healthcare levels in relation to demographics, screening results and organizational factors, and how this influenced treatment of latent tuberculosis. Methods: All asylum seekers ≥18 years with a Mantoux test ≥6 mm or positive x-ray findings who arrived at the National Reception Centre from January 2005 to June 2006, were included. Data were collected from public health authorities in the municipality where the asylum seekers had moved, and from internists in case they had been referred to a specialist. Specialists are responsible for treating latent tuberculosis. Individual subjects were matched with the National Tuberculosis Register to which everybody who had started treatment for latent tuberculosis was reported. Results: Of 4,643 asylum seekers, 2,237 fulfilled the inclusion criteria. By May 2008, 30 persons had started treatment for latent TB, a median of 17 months (range 3—36) after arrival. A Mantoux test ≥15 mm on arrival was significantly associated with treatment. Demographic factors influenced follow-up in primary healthcare while screening results did not. Referral to specialist was related to screening results. Several specialists were reluctant to diagnose and treat latent tuberculosis and to treat persons without a permanent visa in particular. Conclusions: Just 1% of the study group received treatment for latent tuberculosis and with a long time delay. The reason for this may be organizational factors affecting follow-up and referral and specialists not following current guidelines. © 2010, the Nordic Societies of Public Health. All rights reserved.

Author Keywords

Screening Immigrant tuberculosis Immigration Refugee

Index Keywords

refugee Registries mass screening Norway methodology Follow-Up Studies register follow up human Refugees middle aged Cohort Studies ethnology Young Adult Humans Mass Chest X-Ray male Emigrants and Immigrants latent tuberculosis female gamma interferon immunology Article tuberculin test adult migration thorax radiography cohort analysis Interferon-gamma
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77951933532&doi=10.1177%2f1403494809353823&partnerID=40&md5=68677f0ad4a035e8e0c1a9b24125ac87
DOI: 10.1177/1403494809353823
ISSN: 14034948
Cited by: 13
Original Language: English