Tuberculosis screening during the 2015 European refugee crisis

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. Refugees or asylum seekers, staying in shared-accommodation are obligated to participate on screening chest X...

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Bibliographic Details
Published in:	BMC public health Vol. 20; no. 1; p. 200
Main Authors:	Tewes, Susanne, Hensen, Bennet, Jablonka, Alexandra, Gawe, Dana, Kastikainen, Maija, Happle, Christine, Carlens, Julia, Berthold, Lars-Daniel, Wacker, Frank
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 07-02-2020 BioMed Central BMC
Subjects:	Abnormalities Adolescent Adult Age Aged Algorithms Biological response modifiers Bronchoscopy Calcification Calcification (Physiology) Cavitation Chest Chest X-ray Chest x-rays Cohort Studies Demographic aspects Diagnosis Diagnostic imaging Diagnostic systems Effusion Emigration and immigration Emigration and Immigration - statistics & numerical data Europe Female Germany - epidemiology Health aspects Health care Humans Infection Infections Interferon Male Mass Screening Middle Aged Migration Onsite Pleural effusion Population Public health Public health movements Refugee Refugees Refugees - statistics & numerical data Rural areas Scars Screening Sputum Statistical analysis Statistics Tuberculosis Tuberculosis - epidemiology Tuberculosis, Pulmonary - epidemiology Womens health Young Adult γ-Interferon Europe Germany United States > US Infection Screening Refugee Tuberculosis Chest X-ray Migration
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Summary:	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. 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. Only in case of TB-suggestive findings on CXR, further diagnostics were arranged (pulmonological examination, follow-up CXR, sputum culture, interferon-gamma release assay, bronchoscopy). Follow-up data was collected in collaboration with the local Public Health Department. Descriptive statistics were calculated using GraphPad Prism software. n = 637 CXR examinations (90%) did not show abnormal findings, n = 54 CXR (8%) showed incidental findings, and n = 14 CXR (2%) were suspicious for acute TB. Of these, n = 14 individuals, eight underwent further TB diagnostics. Active TB was confirmed in one individual (0.001% of the screening cohort). Our cohort reflects current immigrations statistics in Europe and illustrates an overall low TB prevalence amongst individuals entering Germany in 2015. However, our findings support the improvement of diagnostic algorithms.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1471-2458 1471-2458
DOI:	10.1186/s12889-020-8303-y