TY - JOUR
T1 - Lessons learnt from TB screening in closed immigration centres in Italy
AU - Crepet, Anna
AU - Repetto, Ernestina
AU - Al Rousan, Ahmad
AU - Schepisi, Monica Sané
AU - Girardi, Enrico
AU - Prestileo, Tullio
AU - Codecasa, Luigi
AU - Garelli, Silvia
AU - Corrao, Salvatore
AU - Ippolito, Giuseppe
AU - Decroo, Tom
AU - Maccagno, Barbara
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background: Between June 2012 and December 2013 Médecins Sans Frontières launched a pilot project with the aim of testing a strategy for improving timely diagnosis of active pulmonary TB among migrants hosted in four centres of identification and expulsion (CIE) in Italy. Methods: This is a descriptive study. For active TB case finding we used an active symptom screening approach among migrants at admission in four CIE's. Here we describe the feasibility and the yield of this programme. Results: Overall, 3588 migrants were screened, among whom 87 (2.4%) had a positive questionnaire. Out of 30 migrants referred for further investigations, three were diagnosed as having TB, or 0.1% out of 3588 individuals that underwent screening. Twenty-five (29%, 25/87) migrants with positive questionnaires were not referred for further investigation, following the doctors" decision; however, for 32 (37%, 32/87) migrants the diagnostic work-out was not completed. In multivariate analyses, being over 35 years (OR 1.7; 95% CI 1.12.6) and being transgender (OR 4.9; 95% CI 2.1-11.7), was associated with a positive questionnaire. Conclusions: TB screening with symptom screening questionnaires of migrants at admission in closed centres is feasible. However, to improve the yield, follow-up of patients with symptoms or signs suggestive for TB needs to be improved.
AB - Background: Between June 2012 and December 2013 Médecins Sans Frontières launched a pilot project with the aim of testing a strategy for improving timely diagnosis of active pulmonary TB among migrants hosted in four centres of identification and expulsion (CIE) in Italy. Methods: This is a descriptive study. For active TB case finding we used an active symptom screening approach among migrants at admission in four CIE's. Here we describe the feasibility and the yield of this programme. Results: Overall, 3588 migrants were screened, among whom 87 (2.4%) had a positive questionnaire. Out of 30 migrants referred for further investigations, three were diagnosed as having TB, or 0.1% out of 3588 individuals that underwent screening. Twenty-five (29%, 25/87) migrants with positive questionnaires were not referred for further investigation, following the doctors" decision; however, for 32 (37%, 32/87) migrants the diagnostic work-out was not completed. In multivariate analyses, being over 35 years (OR 1.7; 95% CI 1.12.6) and being transgender (OR 4.9; 95% CI 2.1-11.7), was associated with a positive questionnaire. Conclusions: TB screening with symptom screening questionnaires of migrants at admission in closed centres is feasible. However, to improve the yield, follow-up of patients with symptoms or signs suggestive for TB needs to be improved.
KW - Immigration detention centres
KW - Italy
KW - Migrants
KW - Questionnaire
KW - Screening
KW - Tuberculosis
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U2 - 10.1093/inthealth/ihw025
DO - 10.1093/inthealth/ihw025
M3 - Article
AN - SCOPUS:84995780900
VL - 8
SP - 324
EP - 329
JO - International Health
JF - International Health
SN - 1876-3413
IS - 5
ER -