Sequential strategy for the LTBI screening of newly-arrived immigrants in vulnerable social situations
| Autor: | Antoni Soriano-Arandes, Núria Serre-Delcor, Carlos Ascaso, Begoña Treviño-Maruri, Inés Oliveira-Souto, Israel Molina, Mateu Espasa, M. Teresa Tórtola, Manuel Fernández-Quevedo |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Asia Adolescent Social Determinants of Health Cost-Benefit Analysis media_common.quotation_subject 030106 microbiology Immigration Emigrants and Immigrants Tuberculin Vulnerable Populations Kappa index Young Adult 03 medical and health sciences 0302 clinical medicine Latent Tuberculosis Prevalence Humans Mass Screening Medicine Europe Eastern 030212 general & internal medicine Africa South of the Sahara Retrospective Studies media_common Latent tuberculosis Tuberculin Test business.industry Vaccination International health Skin test Sequential screening bacterial infections and mycoses Active tuberculosis medicine.disease Latin America Spain BCG Vaccine Female business Interferon-gamma Release Tests Demography |
| Zdroj: | Enfermedades infecciosas y microbiologia clinica (English ed.). 36:550-554 |
| ISSN: | 2529-993X |
| DOI: | 10.1016/j.eimce.2017.10.016 |
| Popis: | Introduction Some studies indicate high prevalences of latent tuberculosis infection (LTBI) in the immigrant population, which is relevant because 5–10% of cases will develop active tuberculosis. The objective of this study is to describe the results of a sequential strategy in the newly-arrived immigrant population for the diagnosis of LTBI using the tuberculin skin test (TST) and IGRAs. Methods A retrospective descriptive study was carried out with immigrants between 6 and 35 years of age from shelters, referred to an international health unit between July 2013 and June 2016. The TST was performed and when it was ≥5 mm, IGRAs were conducted. LTBI was defined as an IGRA ≥0.35 IU/ml and normal chest X -ray. Results Of the 184 cases, 138 (75.0%) were men, 23.0 years of age. The most common geographical areas were: 63 (34.2%) from Asia, 42 (22.8%) from Eastern Europe and 41 (22.3%) from sub-Saharan Africa. The TST was ≥10 mm in 79 cases (42.9%). The prevalence of LTBI using the sequential strategy was 33/184 (17.9%). Cohen's Kappa index (between TST ≥ 10 mm and IGRAs) was 0.226. Conclusion Basing LTBI screening on the TST alone could give rise to an overestimation. Some studies show that sequential screening would be the most cost-effective; this seems most evident in BCG-vaccinated populations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect