Screening program for latent tuberculosis infection in asylum seekers - a single center experience in Pavia, Italy

Ann Ig. 2020 Nov-Dec;32(6):682-688. doi: 10.7416/ai.2020.2388.

Abstract

Background: The management of Latent Tuberculosis Infection is crucial in fighting Tuberculosis worldwide, and particularly in low incidence European Countries. While guidelines for the management of Tuberculosis in newly arrived immigrants have been issued by the European Center for Disease Control and Prevention and by the National Health Authorities in Italy, these are not widely implemented yet at local level.

Study design: We report our program for the screening of Latent Tuberculosis Infection and active Tuberculosis in asylum seekers, jointly implemented by Public Health Authorities and the Infectious Diseases Department of a tertiary care, teaching hospital in Northern Italy.

Methods: We reviewed records of the asylum seekers who were screened at our center via Tuberculin Skin Test and/or Interferon Gamma Release Assay plus chest X-ray and either treated with Isoniazid Preventive Treatment or for active Tuberculosis Disease in case of positive results.

Results: We screened 726 migrants, mostly males (97.3%) and from Sub-Saharan Africa (82.2%) and found a high adherence rate for both screening (98.2%) and Isoniazid Preventive Treatment (90.1%). In addition, we found seven cases of active Tuberculosis.

Conclusions: Latent Tuberculosis Infection screening and treatment proved feasible in our program, which should be systematically implemented in asylum seekers reaching Europe.

Keywords: Asylum seekers; Diagnosis; IGRA test; Isoniazid preventive treatment (IPT); LTBI; Latent tuberculosis infection; Quantiferon; Screening programs.

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara / ethnology
  • Algorithms
  • Antitubercular Agents / therapeutic use
  • Asia, Southeastern / ethnology
  • Bronchoalveolar Lavage Fluid / microbiology
  • Female
  • Humans
  • Interferon-gamma Release Tests
  • Isoniazid / therapeutic use
  • Italy / epidemiology
  • Latent Tuberculosis / diagnosis
  • Latent Tuberculosis / diagnostic imaging
  • Latent Tuberculosis / drug therapy
  • Latent Tuberculosis / epidemiology*
  • Male
  • Mass Screening* / statistics & numerical data
  • Mediterranean Region / ethnology
  • Mycobacterium tuberculosis / isolation & purification
  • Patient Compliance
  • Prevalence
  • Program Evaluation
  • Refugees*
  • Retrospective Studies
  • Sputum / microbiology
  • Tuberculin Test
  • Young Adult

Substances

  • Antitubercular Agents
  • Isoniazid