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Open Access Research article

Tuberculosis case finding based on symptom screening among immigrants, refugees and asylum seekers in Rome

Monica Sañé Schepisi1, Gina Gualano2, Claudia Fellus13, Nazario Bevilacqua2, Marco Vecchi2, Pierluca Piselli1, Giuliana Battagin2, Giulia Silvestrini4, Andrea Attanasio4, Alberto Vela5, Giorgia Rocca6, Alessandro Rinaldi6, Pietro Benedetti6, Salvatore Geraci4, Francesco Nicola Lauria2 and Enrico Girardi1*

Author Affiliations

1 Clinical Epidemiology Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases, IRCCS L. Spallanzani, Rome, Italy

2 Respiratory Infectious Diseases Unit, Department of Clinical Research, National Institute for Infectious Diseases, IRCCS L. Spallanzani, Rome, Italy

3 Local Health Unit AUSL RM D, Rome, Italy

4 Caritas Health Service Network, Rome, Italy

5 Local Health Unit AUSL RM H, STP Referral Centre, Nettuno (Rome), Italy

6 "Salute per i migranti forzati" - SaMiFo – Health for forced migrants, Centro Astalli - Local Health Unit AUSL RM A, Rome, Italy

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BMC Public Health 2013, 13:872  doi:10.1186/1471-2458-13-872

Published: 22 September 2013

Abstract

Background

In Italy the proportion of cases of tuberculosis in persons originating from high-prevalence countries has been increasing in the last decade. We designed a study to assess adherence to and yield of a tuberculosis screening programme based on symptom screening conducted at primary care centres for regular and irregular immigrants and refugees/asylum seekers.

Methods

Presence of symptoms suggestive of active tuberculosis was investigated by verbal screening in migrants presenting for any medical condition to 3 free primary care centres in the province of Rome. Individuals reporting at least one symptom were referred to a tuberculosis clinic for diagnostic workup.

Results

Among 2142 migrants enrolled, 254 (11.9%) reported at least one symptom suggestive of active tuberculosis and 176 were referred to the tuberculosis clinic. Of them, 80 (45.4%) did not present for diagnostic evaluation. Tuberculosis was diagnosed in 7 individuals representing 0.33% of those screened and 7.3% of those evaluated for tuberculosis.

Conclusion

The overall yield of this intervention was in the range reported for other tuberculosis screening programmes for migrants, although we recorded an unsatisfactory adherence to diagnostic workup. Possible advantages of this intervention include low cost and reduced burden of medical procedures for the screened population. Further evaluation of this approach appears to be warranted.

Keywords:
Migrants; Tuberculosis; Active case finding; Adherence to screening; Access to care