Tuberculosis screening programme for undocumented immigrant teenagers using the QuantiFERON®-TB Gold In-Tube test

Salinas, Carlos; Ballaz, Aitor; Díez, Rosa; Aguirre, Urko; Antón, Ane; Altube, Lander

doi:10.1016/j.medcle.2013.12.003

Cited by 4 publications

(7 citation statements)

References 28 publications

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“…15 In patients with LTI, the highest risk of reactivation occurs during the first year after arrival to the host country, 16 thus screening may be indicated by means of tuberculin skin test and/or TB interferon-gamma release assays (IGRAs). In our case, LTI figures are significantly higher than those of recent studies carried out in our country, 17,18 the difference probably due to the different origin of the immigrant population included. In the study by Salinas et al, 18 performed in a center of undocumented minor immigrants, the most important group being Moroccans, the percentage of subjects with tuberculin skin test > 5 mm was 34%.…”

Section: Discussioncontrasting

confidence: 88%

“…In our case, LTI figures are significantly higher than those of recent studies carried out in our country, 17,18 the difference probably due to the different origin of the immigrant population included. In the study by Salinas et al, 18 performed in a center of undocumented minor immigrants, the most important group being Moroccans, the percentage of subjects with tuberculin skin test > 5 mm was 34%. Moreover, in our center the use of IGRAs is limited to certain circumstances (children, immunocompromised patients) so LTI figures, exclusively determined by tuberculin skin test, may be slightly overestimated given the high rate of Bacillus Calmette-Guerin (BCG) vaccination and the risk of atypical Mycobacterium infections among the studied population.…”

Section: Discussioncontrasting

confidence: 88%

See 1 more Smart Citation

Newly Arrived African Migrants to Spain: Epidemiology and Burden of Disease

Salas-Coronas

Cabezas-Fernández

Lozano-Serrano

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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The aim of this study is to describe the epidemiological profile, clinical characteristics, and microbiological findings in African immigrants newly arrived to Spain attended at a specialized reference unit from October 2004 to February 2017. A common protocol for the screening of imported and cosmopolitan diseases was designed to evaluate patients with ≤ 12 months of stay in Spain. A total of 523 patients were included in the study, 488 (93.3%) of sub-Saharan origin. A high number of helminthic infections were diagnosed in sub-Saharan patients, including geohelminthiasis (hookworms 14.3%; 4.1%; 3.1%), schistosomiasis (12.3%), strongyloidiasis (17.2%), and filariasis (8.4%). Thirty-five patients (7.2%) had malaria, most by Among communicable diseases, 33.6% of sub-Saharans presented HBsAg positivity compared with 5.7% of North African patients ( = 0.001). Thirteen patients were diagnosed with active tuberculosis. Seventy percent of the sub-Saharans and 40% of the North Africans who were tested had a latent tuberculosis infection (LTI). Treatment of LTI was administered in selected cases (14%), achieving end of treatment in 80% of them. In light of these results, effective screening strategies, particularly within the sub-Saharan immigrant population, including potentially communicable diseases and certain potentially serious parasitic diseases (, ), should be implemented. It is necessary to facilitate fully and free of charge access to the public health system to newly arrived immigrants, as well as to implement programs and actions aimed at favoring care and follow-up, especially for communicable diseases. Empirical treatment of some parasitic diseases could be a cost-effective action.

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Section: Discussioncontrasting

confidence: 88%

Section: Discussioncontrasting

confidence: 88%

Newly Arrived African Migrants to Spain: Epidemiology and Burden of Disease

Salas-Coronas

Cabezas-Fernández

Lozano-Serrano

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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“…35 Nevertheless, the use of new interferon-gamma assays (IGRAs) could solve this limitation, although its high cost has precluded its widespread use in some resource-strained public health settings by the World Health Organization. 12,34,36 In a previous study in Almeria, molecular analyses detected the transmission of TB between immigrants and the autochthonous population. 17 Therefore, as recommended in international guidelines, TB screening protocols (including IGRAs if possible) are recommended in newly arrived immigrants from areas with a high prevalences of TB (≥ 20 cases per 100,000 inhabitants) to achieve early diagnosis and treatment of active or latent infection.…”

Section: Discussionmentioning

confidence: 95%

Infectious Diseases in Sub-Saharan Immigrants to Spain

Serre-Delcor¹,

Maruri²,

Soriano‐Arandes³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Immigrants may be carriers of infectious diseases because of the prevalence of these diseases in their country of origin, exposure during migration, or conditions during resettlement, with this prevalence being particularly high in sub-Saharan Africans. We performed a retrospective review of 180 sub-Saharan immigrants screened for infectious diseases at an International Health Center from January 2009 to December 2012. At least one pathogenic infectious disease was diagnosed in 72.8% patients: 60.6% latent tuberculosis infection, 36.8% intestinal parasites (intestinal protozoa or helminths), 28.1% helminths, 14.8% hepatitis B surface antigen positive, 1.2% anti-hepatitis C virus positive, 1.2% human immunodeficiency virus-positive, and 1.2% malaria. Coinfections were present in 28.4%. There was significant association between eosinophilia (absolute count or percentage) or hyper-IgE and the presence of helminths (P < 0.001). Relative eosinophilia and hyper-IgE were better indicators of helminth infection than absolute eosinophilia, particularly for schistosomiasis and strongyloidiasis. We found a high prevalence of infectious diseases in sub-Saharan immigrants, which could lead to severe health problems (in the absence of prompt treatment), representing a high cost to the public health system and possible transmission in the host country. Accurate screening and tailored protocols for infectious diseases are recommended in sub-Saharan immigrants.

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“…Overall, 10 studies evaluated a screening program or strategy in a Canadian Indigenous [ 24 ] or high-risk paediatric population in a low-burden setting, [ 24 , 28 , 30 – 37 ] whilst 13 others evaluated the effectiveness of IGRAs [ 25 , 26 , 29 , 38 – 47 ] in a paediatric population, one investigated the effect of BCG vaccination on TST-positivity, [ 27 ] and one the effect of age on IGRA positivity [ 48 ]. Relevant characteristics of the included studies that investigated screening strategies are summarized in Table 1 , whilst those evaluating screening tools are summarized in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“… • High failure rates (14 and 15% respectively) of T-SPOT and QFT-GIT • High proportion of inconclusive results for both IGRAs suggests TST remains useful alternative. Salinas [ 47 ] 2015 Spain Undocumented immigrant children (< 19 yrs) in Basque Country, Spain 845 To determine the prevalence of LTBI in undocumented immigrant teenagers using QFT QFT-GIT TST 63% overall, 57% positive and 96% negative concordance. • Screening high-risk subgroups of the population in low-incidence countries is recommended.…”

Section: Resultsmentioning

confidence: 99%

Recommendations for the screening of paediatric latent tuberculosis infection in indigenous communities: a systematic review of screening strategies among high-risk groups in low-incidence countries

2018

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BackgroundTuberculosis (TB) continues to be a global public health concern. Due to the presence of multiple risk factors such as poor housing conditions and food insecurity in Canadian Indigenous communities, this population is at particularly high risk of TB infection. Given the challenges of screening for latent TB infection (LTBI) in remote communities, a synthesis of the existing literature regarding current screening strategies among high-risk groups in low-incidence countries is warranted, in order to provide an evidence base for the optimization of paediatric LTBI screening practices in the Canadian Indigenous context.MethodsA literature search of the Embase and Medline databases was conducted, and studies pertaining the evaluation of screening strategies or screening tools for LTBI in paediatric high-risk groups in low-incidence countries were included. Studies focusing on LTBI screening in Indigenous communities were also included, regardless of whether they focused on a paediatric population. Their results were summarized and discussed in the context of their relevance to screening strategies suitable to the Canadian Indigenous setting. Grey literature sources such as government reports or policy briefs were also consulted.ResultsThe initial literature search returned 327 studies, with 266 being excluded after abstract screening, and 36 studies being included in the final review (original research studies: n = 25, review papers or policy recommendations: n = 11). In the examined studies, case identification and cost-effectiveness of universal screening were low in low-incidence countries. Therefore, studies generally recommended targeted screening of high-risk groups in low-incidence countries, however, there remains a lack of consensus regarding cut-offs for the incidence-based screening of high-risk communities, as well as regarding the utility and prioritization of individual risk-factor-based screening of high-risk groups. The utility of the TST compared to IGRAs for LTBI detection in the pediatric population also remains contested.ConclusionsRelevant strategies for targeted screening in the Canadian Indigenous context include community-level incidence-based screening (screening based on geographic location within high-incidence communities), as well as individual risk-factor-based screening, taking into account pertinent risk factors in Indigenous settings, such as poor housing conditions, malnutrition, contact with an active case, or the presence of relevant co-morbidities, such as renal disease.

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Tuberculosis screening programme for undocumented immigrant teenagers using the QuantiFERON®-TB Gold In-Tube test

Cited by 4 publications

References 28 publications

Newly Arrived African Migrants to Spain: Epidemiology and Burden of Disease

Newly Arrived African Migrants to Spain: Epidemiology and Burden of Disease

Infectious Diseases in Sub-Saharan Immigrants to Spain

Recommendations for the screening of paediatric latent tuberculosis infection in indigenous communities: a systematic review of screening strategies among high-risk groups in low-incidence countries

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