The role of entry screening in case finding of tuberculosis among asylum seekers in Norway
The role of entry screening in case finding of tuberculosis among asylum seekers in Norway
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DOI：
10.1186/1471-2458-10-670
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发表时间：
2010-11-04
影响因子：
4.5
通讯作者：
Garasen, Helge
中科院分区：
文献类型：
--
作者：
Harstad, Ingunn;Jacobsen, Geir W.;Garasen, Helge
背景：挪威目前大多数新的活动性结核病病例是由输入菌株引起的，而不是在该国境内传播。寻求庇护者在抵达时必须通过曼图测试对每个人进行结核病筛查，并对 15 岁以上的人进行胸部 X 光检查。我们的目的是评估对一群寻求庇护者进行入境筛查的有效性。将筛查发现的病例与后来发现的病例进行比较。此外，我们还对活动性结核病病例进行了特征分析。 方法：所有在 2005 年 1 月至 2006 年 6 月期间到达国家接待中心且胸部 X 光检查异常或 Mantoux 测试≥ 6 mm 的寻求庇护者均被纳入研究，并通过医疗保健系统进行跟踪。 2008 年 5 月底，他们与国家结核病登记册进行了匹配。到达后两个月内报告的病例被定义为通过筛查发现的。结果：在 4643 名符合条件的寻求庇护者中，2237 名被纳入研究。共有 2077 人的 Mantoux 值 >= 6 mm，其中 314 人的胸部 X 光检查结果异常。在 28 例结核病例中，15 例是通过筛查发现的，13 例是在抵达后 4-27 个月发现的。在通过筛查发现的人群中，到达时 X 射线异常的情况更为普遍。女性和索马里血统增加了活动性结核病的风险。结论：尽管筛查结果的后续工作不完善，但该计划还是发现了合理数量的结核病病例，其中以肺结核为主。
Background: Most new cases of active tuberculosis in Norway are presently caused by imported strains and not transmission within the country. Screening for tuberculosis with a Mantoux test of everybody and a chest X-ray of those above 15 years of age is compulsory on arrival for asylum seekers.We aimed to assess the effectiveness of entry screening of a cohort of asylum seekers. Cases detected by screening were compared with cases detected later. Further we have characterized cases with active tuberculosis.Methods: All asylum seekers who arrived at the National Reception Centre between January 2005 - June 2006 with an abnormal chest X-ray or a Mantoux test >= 6 mm were included in the study and followed through the health care system. They were matched with the National Tuberculosis Register by the end of May 2008. Cases reported within two months after arrival were defined as being detected by screening.Results: Of 4643 eligible asylum seekers, 2237 were included in the study. Altogether 2077 persons had a Mantoux >= 6 mm and 314 had an abnormal chest X-ray. Of 28 cases with tuberculosis, 15 were detected by screening, and 13 at 4-27 months after arrival. Abnormal X-rays on arrival were more prevalent among those detected by screening. Female gender and Somalian origin increased the risk for active TB.Conclusion: In spite of an imperfect follow-up of screening results, a reasonable number of TB cases was identified by the programme, with a predominance of pulmonary TB.