Agostina Pontarelli1, Valentina Marchese2, Carla Scolari3, Susanna Capone4, Issa El-Hamad5, Francesco Donato6, Rolando Moioli7, Enrico Girardi8, Daniela Maria Cirillo9, Francesco Castelli10, Alberto Matteelli11. 1. University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy. Electronic address: agostinapontarelli@gmail.com. 2. University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy; Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy. Electronic address: v.marchese@unibs.it. 3. Unità Distretto Territoriale, ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy. Electronic address: carla.scolari@asst-spedalicivili.it. 4. Unità Distretto Territoriale, ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy. Electronic address: susanna.caponemed@gmail.com. 5. University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy; Unità Distretto Territoriale, ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy. Electronic address: issa1957@libero.it. 6. Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy. Electronic address: francesco.donato@unibs.it. 7. Centro Pneumologico Preventivo, ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy. Electronic address: rolando.moioli@asst-spedalicivili.it. 8. Clinical Epidemiology Unit, Lazzaro Spallanzani National Institute for Infectious Diseases, Via Portuense, 292, 00149, Rome, Italy. Electronic address: enrico.girardi@inmi.it. 9. IRCCS San Raffaele Scientific Institute, Via Olgettina Milano, 60, 20132, Milan, Italy. Electronic address: cirillo.daniela@hsr.it. 10. University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy. Electronic address: francesco.castelli@unibs.it. 11. University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy. Electronic address: alberto.matteelli@unibs.it.
Abstract
BACKGROUND: The World Health Organization conditionally recommends systematic screening of tuberculosis (TB) and Latent Tuberculosis Infection (LTBI) among asylum seekers (AS) from high-burden countries, but the effectiveness of different screening approaches is controversial. METHODS: We report the results of a retrospective cohort analysis of TB and LTBI screening among consecutive AS in Brescia, Italy during 2015-2016. TB screening was based on symptoms, LTBI screening on the tuberculin skin test (TST). Logistic regression analysis was performed to identify factors associated with screening uptake. RESULTS: Of 2904 registered AS 2567 (88.4%) were evaluated for TB, 62 (2.4%) had symptoms and active TB yield was 155/100,000. Prevalence and incidence TB rates were 545/100,000 persons and 220/100,000 person-years. Questionnaire screening identified 28.6% (4/14) prevalent cases. Of 2303 (89.7%) AS with TST result, the positivity rate was 36.6% (843/2303). Of the 843 candidates for LTBI treatment 413 (49.0%) completed the screening. LTBI treatment was prescribed to 190 (47.9%) of 397 eligible individuals, 10.8% (91) completed treatment. CONCLUSIONS: TB prevalence and incidence rates were high in this AS population, but symptom-based screening performed poorly. LTBI cascade losses were significant and mainly attributable to the defragmentation of the health care system.
BACKGROUND: The World Health Organization conditionally recommends systematic screening of tuberculosis (TB) and Latent Tuberculosis Infection (LTBI) among asylum seekers (AS) from high-burden countries, but the effectiveness of different screening approaches is controversial. METHODS: We report the results of a retrospective cohort analysis of TB and LTBI screening among consecutive AS in Brescia, Italy during 2015-2016. TB screening was based on symptoms, LTBI screening on the tuberculin skin test (TST). Logistic regression analysis was performed to identify factors associated with screening uptake. RESULTS: Of 2904 registered AS 2567 (88.4%) were evaluated for TB, 62 (2.4%) had symptoms and active TB yield was 155/100,000. Prevalence and incidence TB rates were 545/100,000 persons and 220/100,000 person-years. Questionnaire screening identified 28.6% (4/14) prevalent cases. Of 2303 (89.7%) AS with TST result, the positivity rate was 36.6% (843/2303). Of the 843 candidates for LTBI treatment 413 (49.0%) completed the screening. LTBI treatment was prescribed to 190 (47.9%) of 397 eligible individuals, 10.8% (91) completed treatment. CONCLUSIONS: TB prevalence and incidence rates were high in this AS population, but symptom-based screening performed poorly. LTBI cascade losses were significant and mainly attributable to the defragmentation of the health care system.
Authors: F Naufal; L H Chaisson; K O Robsky; P Delgado-Barroso; H S Alvarez-Manzo; C R Miller; A E Shapiro; J E Golub Journal: Int J Tuberc Lung Dis Date: 2022-06-01 Impact factor: 3.427
Authors: Susanne Tewes; Bennet Hensen; Alexandra Jablonka; Dana Gawe; Maija Kastikainen; Christine Happle; Julia Carlens; Lars-Daniel Berthold; Frank Wacker Journal: BMC Public Health Date: 2020-02-07 Impact factor: 3.295
Authors: Tullio Prestileo; Giuseppe Pipitone; Adriana Sanfilippo; Antonio Ficalora; Giuseppe Natoli; Salvatore Corrao Journal: J Trop Med Date: 2021-03-30