In contrast, the majority of European countries are performing a chest radiograph (CXR)–based active TB screening [9]. J Your comment will be reviewed and published at the journal's discretion. The preliminary findings of a tuberculosis (TB) screening of asylum seekers performed in a reception center located in northern Italy reveal a post-entry screening prevalence rate of 535 per 100000 individuals screened. , Robotic Enucleation for Esophageal Benign and Borderline Tumors: Less is More? Lönnroth Because the rates of active and latent TB (LTBI) in migrants often correspond to those of their countries of origin, targeted interventions are recommended in this population to address its special needs, including screening for active TB and LTBI, and appropriate treatment [1]. W The number of arrivals by sea to the Italian coasts was estimated to be 66000 in 2014, increasing to 153600 in 2015 [6]. Potential conflicts of interest. Coker Although no studies to compare the performance of different screening approaches in our country have been done yet, our data show the effectiveness of CXR screening in diagnosing patients with active TB who did not report symptoms and who would be missed by a symptom-based screening. The action framework proposed by the World Health Organization (WHO) toward TB elimination identifies migrants among the most vulnerable groups. S B MS In the study period, no additional cases of TB among migrants diagnosed after the initial screening have been notified. , 7 . Weber IGRAs, such as QuantiFERON-TB Gold Plus, address many limitations of the century-old tuberculin skin test (TST). , A mobile CXR machine was installed inside the reception center, and all the individuals who agree to be registered in Italy undergo CXR the day after their arrival to the center, regardless the presence of symptoms. Schepisi All the CXRs are read by an experienced radiologist within 3 days: in case of pathological findings, the hub’s medical doctor consults the infectious diseases specialist, who may recommend other investigations such as chest high-resolution computed tomography, collection of respiratory specimens, or admission to hospital. 5 TB Prevention 5.1 Prevention and Health Promotion The . Guidelines prepared by expert panels convened by U.S. government and updated continuously. , All rights reserved. However, few countries use a nationally standardized screening algorithm, with most countries using screening programs adapted to the regional level [3]. , Available at: http://data.unhcr.org/mediterranean/country.php?id=502. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. L Tuberculosis Prevention and Control Protocol, 2018 (or as current) requires that boards of health provide annual education to health care providers and/or community stakeholders, as needed, based on local epidemiology, about the following: HIV/AIDS treatment and prevention medical practice guideline documents and related reports and reference materials. A et al. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. As recently reported [4, 5], there is a need for a more standardized data collection and analysis to better understand the real usefulness, cost-effectiveness, and epidemiological impact of TB screening of migrants in Europe. This information is intended to serve as guidance for clinicians and public health professionals, as well as for those who may be at risk. Manissero Most of the screened migrants came from high-incidence countries and reached Italian coasts via the Mediterranean sea after spending several months in Libya, waiting for the transfer. Global migration due to conflict or humanitarian crisis has dramatically increased in recent decades. W CDC TB Guidelines CDC Resources & MMWR Recommendations and Reports Guides and Toolkits Tuberculosis Program Guideline, 2018 . Gualano All CXRs of TB cases were suggestive of TB and the most represented radiological findings were pulmonary consolidations, micronodules, and cavitations. Infectious Diseases Unit, Department of Medical and Surgical Sciences, St Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Correspondence: Dr E. Vanino, St. Orsola-Malpighi Hospital, via Massarenti 11, 40138, Bologna, Italy (. Semenza If we consider that the estimated prevalence rate in Italy is 6.7 per 100000 population [10], the prevalence found in migrants is 80 times greater. The unit cost of screening was <20 euros per individual screened. During this period, 18 new cases of active TB were diagnosed: all were males, and the mean age was 25 (range, 18–38) years; 84% (n = 15) were from West Africa and the others from the Indian subcontinent. The increasing flow of migrants arriving from countries with high tuberculosis (TB) incidence to lower-incidence European countries (<100 TB cases per million population) raises concerns of TB transmission among migrants/asylum seekers. , Number of Symptomatic and Asymptomatic Individuals Affected by Microbiologically Confirmed or Not Confirmed Tuberculosis. Oxford University Press is a department of the University of Oxford. All those found with TB or LTBI receive proper treatment managed by an infectious diseases team. Global TB Programme: Annabel Baddeley, Ernesto Jaramillo, Avinash Kanchar, Knut Lönnroth, Kefas Samson, ... of the Guidelines Development Group, as broad expertise on latent tuberculosis (TB) was considered a criterion for selection. , van Rest Mean age was 25 (range, 18–41) years and 96% (n = 3236) of them were male. et al. Gait analysis: Comparative evaluation of conventional total knee replacement and modular distal femoral megaprosthesis. K , The revised guidelines contain recommendations for specific administrative, environmental controls and respiratory protection, following the assessment made by an external group of experts convened as members of the Guideline Development Group. Janssens This result shows that systematic use of chest radiography is a useful tool for active TB screening among asylum seekers in Italy.
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