TY - JOUR

T1 - Tuberculosis screening among newly arrived asylum seekers in Denmark

AU - Kristensen, Kristina Langholz

AU - Nørredam, Marie

AU - Jensen, Sidse Graff

AU - Seersholm, Niels

AU - Jorgensen, Marie Louise

AU - Exsteen, Banoo Bakir

AU - Huber, Franziska Grundtvig

AU - Munk-Andersen, Ebbe

AU - Lillebaek, Troels

AU - Ravn, Pernille

PY - 2022

Y1 - 2022

N2 - Background Tuberculosis (TB) screening programmes among asylum seekers tend to focus on chest radiography (CXR) for early diagnosis, whereas knowledge on sputum examination is limited. We evaluated active TB screening using CXR and sputum culture among asylum seekers arriving in Denmark. In addition, we assessed the coverage of a voluntary health assessment. Methods Between 1 February 2017 and 31 March 2019, all newly arrived asylum seekers in Denmark >= 18 years from TB high-incidence countries or risk groups, who attended a voluntary general health assessment, were offered active TB screening with CXR and spot sputum examination. Sputum samples were examined by culture and smear microscopy. Results Coverage of the general health assessment was 65.1%. Among 1,154 referred for active TB screening, 923 (80.0%) attended. Of these, 854 were screened by CXR and one case of active TB was identified equivalent to a yield of 0.12%. Sputum samples were collected from 758 and one M. tuberculosis culture-positive TB case (also identified by CXR) was identified, equivalent to a yield of 0.13%. No cases were found by sputum culture screening only. In addition, screening found three cases of malignant disease. Conclusion We suggest that TB screening should focus on asylum seekers from TB high-incidence countries. Furthermore, early health assessments should be of high priority to ensure migrant health.

AB - Background Tuberculosis (TB) screening programmes among asylum seekers tend to focus on chest radiography (CXR) for early diagnosis, whereas knowledge on sputum examination is limited. We evaluated active TB screening using CXR and sputum culture among asylum seekers arriving in Denmark. In addition, we assessed the coverage of a voluntary health assessment. Methods Between 1 February 2017 and 31 March 2019, all newly arrived asylum seekers in Denmark >= 18 years from TB high-incidence countries or risk groups, who attended a voluntary general health assessment, were offered active TB screening with CXR and spot sputum examination. Sputum samples were examined by culture and smear microscopy. Results Coverage of the general health assessment was 65.1%. Among 1,154 referred for active TB screening, 923 (80.0%) attended. Of these, 854 were screened by CXR and one case of active TB was identified equivalent to a yield of 0.12%. Sputum samples were collected from 758 and one M. tuberculosis culture-positive TB case (also identified by CXR) was identified, equivalent to a yield of 0.13%. No cases were found by sputum culture screening only. In addition, screening found three cases of malignant disease. Conclusion We suggest that TB screening should focus on asylum seekers from TB high-incidence countries. Furthermore, early health assessments should be of high priority to ensure migrant health.

KW - Asylum seekers

KW - tuberculosis

KW - screening

KW - sputum culture

KW - coverage

KW - LOW-INCIDENCE COUNTRIES

KW - MIGRANTS

KW - ENTRY

KW - SURVEILLANCE

KW - IMMIGRANTS

KW - EUROPE

KW - CARE

U2 - 10.1080/23744235.2022.2106380

DO - 10.1080/23744235.2022.2106380

M3 - Journal article

C2 - 36000199

VL - 54

JO - Infectious Diseases

JF - Infectious Diseases

SN - 2374-4235

IS - 11

ER -