Description of the largest cluster of tuberculosis notified in Norway 1997-2011: is the Norwegian tuberculosis control programme serving its purpose for high risk groups?
Description of the largest cluster of tuberculosis notified in Norway 1997-2011: is the Norwegian tuberculosis control programme serving its purpose for high risk groups?
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DOI：
10.1186/s12889-015-1701-x
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发表时间：
2015-04-11
影响因子：
4.5
通讯作者：
Dahle UR
中科院分区：
文献类型：
--
作者：
Guzman Herrador BR;Rønning K;Borgen K;Mannsåker T;Dahle UR
在挪威通报的结核病新病例中，约90%是来自高发病率国家的寻求庇护者和其他移民。寻求庇护者在抵达国家移民中心时接受审查。其他移民会收到一封来自市政卫生服务机构的信，要求他们到居住地进行检查。为了确定结核控制规划可以更好地适应这些群体的潜在领域，我们研究了挪威截至2011年报告的最大结核病例群（“聚类X”）。病例定义为1997年1月至2011年12月期间向MSIS报告的结核病报告，并将相同的IS6110 RFLP分配给X群。我们使用挪威传染病监测系统（MSIS）的数据描述了X群中的病例。从国家接待中心、奥斯陆大学医院和市政保健服务部门获得的MSIS信息缺失或不完整。在符合病例定义的总共44个人中，36人来自索马里，8人来自其他高发国家。29人是寻求庇护者，15人是其他移民。抵达时，18/44被诊断为潜伏性结核感染（LTBI）， 9/44被诊断为LTBI阴性，4/44被诊断为活动性结核。其余13/44人（1名寻求庇护者和12名其他移民）抵达时没有结核病筛查结果。其他12名移民中有5人在挪威待了一年或更长时间后仍未接受结核病筛查。获得结核病筛查结果的大多数病例在抵达挪威时已经感染，这表明他们的疾病可能是由于内源性再激活，而不是抵达挪威后最近的传播。由于缺乏初步筛查，许多其他移民抵达时的结核病状况尚不清楚。应探讨其他移民初始筛查不成功的原因，并实施简化入境结核病筛查的方法。
Approximately 90% of new tuberculosis (TB) cases notified in Norway are asylum seekers and other immigrants from high-incidence countries. Asylum seekers are screened upon arrival at the National Immigration Centre. Other immigrants receive a letter from the Municipal Health Services requesting that they present for screening in their municipality of residence. In order to identify potential areas where the TB control programme could be better adapted for these groups, we studied the largest cluster of TB cases (“cluster X”) notified in Norway until 2011. Cases were defined as TB notifications reported to MSIS between January 1997 and December 2011 with identical IS6110 RFLP assigned to cluster X. We described the cases in cluster X by using data from the Norwegian Surveillance System for Communicable Diseases (MSIS). Missing or incomplete information in MSIS was obtained from the National Reception Centre, Oslo University Hospital and Municipal Health services. Of a total of 44 individuals meeting the case definition, 36 originated from Somalia and eight from other high-incidence countries. Twenty nine were asylum seekers and 15 were other immigrants. Upon arrival, 18/44 had been diagnosed with latent TB infection (LTBI), 9/44 tested negative for LTBI and 4/44 had been diagnosed with active TB. Results of TB-screening upon arrival were not available for the remaining 13/44 (one asylum seeker and 12 other immigrants). Five of the 12 other immigrants had still not been screened for TB after staying one year or longer in Norway. Most cases in cluster X with available results of TB-screening were already infected at arrival, indicating that their disease could be due to endogenous reactivation, rather than recent transmission after arrival to Norway. TB-status upon arrival was unknown for many of the other immigrants due to lack of initial screening. The reasons why conduction of the initial screening among other immigrants is failing should be explored and methods to simplify the TB screening at arrival should be implemented.
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影响因子：
4.5
作者：
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通讯作者：
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Lalvani, Ajit