Tuberculosis care among refugees arriving in Europe: a ERS/WHO Europe Region survey of current practices (original) (raw)
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Call for urgent actions to ensure access to early diagnosis and care of tuberculosis among refugees
European Respiratory Journal, 2016
ERSpublications ERS and the European Region of The Union call for prioritisation of TB care, prevention and control among refugees http://ow.ly/YYCL8 Tuberculosis (TB) is a major cause of mortality from an infectious disease, globally affecting 9.6 million cases, with 1.5 million deaths in 2014 [1]. In 2014, there were 273 381 TB cases reported in the World Health Organization (WHO) European region, and an estimated 33 000 deaths [2]. Vulnerable populations (i.e. individuals affected by discrimination, hostility or economic adversity), which often include migrants and refugees, have an increased risk of suffering from TB disease [1, 3, 4]. If this is not efficiently addressed, the exposure of these groups to Mycobacterium tuberculosis strains may lead to a rise in the number of cases of disease and related deaths, as well as contributing to a further increase in drug-resistant TB cases. Several factors have contributed to the increase of population mobility in the WHO European region [3]. This rise in the level of cross-border movement has increased the need for collaboration between national
European Respiratory Journal, 2016
ERSpublications ERS and the European Region of The Union call for prioritisation of TB care, prevention and control among refugees http://ow.ly/YYCL8 Tuberculosis (TB) is a major cause of mortality from an infectious disease, globally affecting 9.6 million cases, with 1.5 million deaths in 2014 [1]. In 2014, there were 273 381 TB cases reported in the World Health Organization (WHO) European region, and an estimated 33 000 deaths [2]. Vulnerable populations (i.e. individuals affected by discrimination, hostility or economic adversity), which often include migrants and refugees, have an increased risk of suffering from TB disease [1, 3, 4]. If this is not efficiently addressed, the exposure of these groups to Mycobacterium tuberculosis strains may lead to a rise in the number of cases of disease and related deaths, as well as contributing to a further increase in drug-resistant TB cases. Several factors have contributed to the increase of population mobility in the WHO European region [3]. This rise in the level of cross-border movement has increased the need for collaboration between national
Tuberculosis screening during the 2015 European refugee crisis
BMC Public Health, 2020
Background The purpose of our study was to describe and evaluate management, performance and results of Tuberculosis (TB)-screening among refugees and asylum seekers in a rural area in Germany in 2015. Methods Refugees or asylum seekers, staying in shared-accommodation are obligated to participate on screening chest X-ray (CXR) in order to screen for signs of potentially infectious pulmonary TB (German Protection against Infection Act and German Asylum Procedure Act). n = 705 individuals underwent screening chest X-ray (CXR) to detect pulmonary TB in September and October 2015 on site. One experienced radiologist interpreted and reported each CXR within 24 h after the enrollment in the screening program and results were sent to the local Public Health Department for potential further medical care. Image abnormalities suggestive for TB were defined according to established radiographic criteria such as pleural effusion, cavitation, consolidation, fibrous scarring or calcification. On...
Preventing and controlling tuberculosis among refugees in Europe: more is needed
The European respiratory journal, 2016
We read with interest the study by DE VRIES et al. [1] reporting on the results of tuberculosis screening among recently arrived migrants and refugees in the Netherlands. This study brings several issues for debate in a moment where migration to Europe generates concerns and potential risks for stigmatisation and discrimination. In 2015, >1 million migrants and refugees reached Europe by different routes, more than four times more people than in 2014 (when there were only 219 000) [2, 3].
Active and latent tuberculosis in refugees and asylum seekers: a systematic review and meta-analysis
BMC PUBLIC HEALTH, 2020
Background: In 2018, there were 70.8 million refugees, asylum seekers and persons displaced by wars and conflicts worldwide. Many of these individuals face a high risk for tuberculosis in their country of origin, which may be accentuated by adverse conditions endured during their journey. We summarised the prevalence of active and latent tuberculosis infection in refugees and asylum seekers through a systematic literature review and metaanalyses by country of origin and host continent. Methods: Articles published in Medline, EMBASE, Web of Science and LILACS from January 2000 to August 2017 were searched for, without language restriction. Two independent authors performed the study selection, data extraction and quality assessment. Random effect models were used to estimate average measures of active and latent tuberculosis prevalence. Subgroup meta-analyses were performed according to country of origin and host continent. Results: Sixty-seven out of 767 identified articles were included, of which 16 entered the meta-analyses. Average prevalence of active and latent tuberculosis was 1331 per 100 thousand inhabitants [95% confidence interval (CI) = 542-2384] and 37% (95% CI = 23-52%), respectively, both with high level of heterogeneity (variation in estimative attributable to heterogeneity [I 2 ] = 98.2 and 99.8%). Prevalence varied more according to countries of origin than host continent. Ninety-one per cent of studies reported routine screening of recently arrived immigrants in the host country; two-thirds confirmed tuberculosis bacteriologically. Many studies failed to provide relevant information. Conclusion: Tuberculosis is a major health problem among refugees and asylum seekers and should be given special attention in any host continent. To protect this vulnerable population, ensuring access to healthcare for early detection for prevention and treatment of the disease is essential.
Screening and treatment for latent tuberculosis infection among asylum seekers entering Switzerland
Swiss medical weekly, 2002
To evaluate the compliance of doctors and patients with the current recommendations for screening and preventive treatment of immigrants with a positive tuberculin skin test (TST) suggestive of latent tuberculosis infection (LTBI). Retrospective cohort study of all asylum seekers entering Switzerland between 1 January 1993 and 31 December 1993 and assigned to the cantons of Aargau, Fribourg, Geneva, Neuchâtel, Valais and Vaud, who underwent a TST at the border. The medical documents of all individuals with a TST size suggestive of LTBI (> or = 10 mm in children <15 years, > or = 18 mm in young adults aged 15-25 years) were reviewed for final diagnosis, therapeutic decision, compliance with treatment if prescribed, and notification for tuberculosis within the next 3 years. Among 2515 asylum seekers, 172 had a positive TST suggestive of LTBI. The documents of 93 persons were available. The final diagnosis was LTBI in 71 cases, possible tuberculosis in 10 cases, an effect of B...
Latent tuberculosis screening and treatment among asylum seekers: a mixed-methods study
European Respiratory Journal, 2019
IntroductionEvidence on conditions for implementation of latent tuberculosis infection (LTBI) screening and treatment among asylum seekers is needed to inform tuberculosis (TB) control policies. We used mixed-methods to evaluate the implementation of an LTBI screening and treatment programme among asylum seekers in the Netherlands.MethodsWe offered voluntary LTBI screening to asylum seekers aged ≥12 years living in asylum seeker centres from countries with a TB incidence >200 per 10 000 population. We calculated LTBI screening and treatment cascade coverage, and assessed associated factors with Poisson regression using robust variance estimators. We interviewed TB care staff (seven group interviews) and Eritrean clients (21 group and 21 individual interviews) to identify programme enhancers and barriers.ResultsWe screened 719 (63% of 1136) clients for LTBI. LTBI was diagnosed among 178 (25%) clients; 149 (84%) initiated LTBI treatment, of whom 129 (87%) completed treatment. In-pe...
Screening for Tuberculosis in Migrants: A Survey by the Global Tuberculosis Network
Antibiotics
Tuberculosis (TB) does not respect borders, and migration confounds global TB control and elimination. Systematic screening of immigrants from TB high burden settings and—to a lesser degree TB infection (TBI)—is recommended in most countries with a low incidence of TB. The aim of the study was to evaluate the views of a diverse group of international health professionals on TB management among migrants. Participants expressed their level of agreement using a six-point Likert scale with different statements in an online survey available in English, French, Mandarin, Spanish, Portuguese and Russian. The survey consisted of eight sections, covering TB and TBI screening and treatment in migrants. A total of 1055 respondents from 80 countries and territories participated between November 2019 and April 2020. The largest professional groups were pulmonologists (16.8%), other clinicians (30.4%), and nurses (11.8%). Participants generally supported infection control and TB surveillance esta...