Eurosurveillance
Volume 23, Issue 11, 2018

Screening and prevention of infectious diseases in newly arrived migrants. Find and treat or find and lose? Tuberculosis treatment outcomes among screened newly arrived asylum seekers in Germany 2002 to 2014 (Article) (Open Access)

Kuehne A. , Hauer B. , Brodhun B. , Haas W. , Fiebig L.*
  • a Robert Koch Institute, Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany, Robert Koch Institute, Berlin, Germany, ECDC, Stockholm, Sweden
  • b Robert Koch Institute, Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany
  • c Robert Koch Institute, Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany
  • d Robert Koch Institute, Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany
  • e Robert Koch Institute, Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany

Abstract

Background: Germany has a low tuberculosis (TB) incidenceA relevant and increasing proportion of TB casesis diagnosed among asylum seekers upon screening Aim: We aimed to assess whether cases identifiedby screening asylum seekers had equally successful and completely reported treatment outcomes as cases diagnosed by passive case finding and contact tracing in the general population. Methods: We analysed characteristics and treatment outcomes of pulmonary TB cases notified in Germany between 2002 and 2014, stratified by mode of case finding. We performed three multivariable analyses with different dependent variables: Model A: successful vs all other outcomes, Model B: successful vs documented non-successful clinical outcome and Model C: known outcome vs lost to follow-up. Results: TB treatment success was highest among cases identified by contact tracing (87%; 3,139/3,591), followed by passive case finding (74%; 28,804/39,019) and by screening asylum seekers (60%; 884/1,474). Cases identified by screening asylum seekers had 2.4 times higher odds of not having a successful treatment outcome as opposed to all other outcomes (A), 1.4 times higher odds of not having a successful treatment outcome as opposed to known non-successful outcomes (B) and 2.3 times higher odds of loss to follow-up (C) than cases identified by passive case finding. Conclusion: Screened asylum seekers had poorer treatment outcomes and were more often lost to follow-up. Linking patients to treatment facilities and investigating potential barriers to treatment completion are needed to secure screening benefits for asylum seekers and communities. © 2018, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

Author Keywords

[No Keywords available]

Index Keywords

Germany Europe, Eastern refugee mass screening human Communicable Diseases Refugees Asia middle aged Aged Eastern Europe ethnology procedures Young Adult Humans lung tuberculosis tuberculostatic agent Antitubercular Agents Adolescent Treatment Outcome Tuberculosis, Pulmonary male female communicable disease control Africa contact examination Incidence Contact Tracing communicable disease adult migration Emigration and Immigration Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85044793008&doi=10.2807%2f1560-7917.ES.2018.23.11.17-00042&partnerID=40&md5=d20e0c0eaa7a32b5f08850f306c34a60
DOI: 10.2807/1560-7917.ES.2018.23.11.17-00042
ISSN: 1025496X
Cited by: 2
Original Language: English