Abstract
BackgroundScreening and treatment of latent tuberculosis infection (LTBI) in asylum seekers (AS) may prevent future cases of tuberculosis. As the screening with Interferon Gamma Release Assay (IGRA) is costly, the objective of this study was to assess which factors were associated with LTBI and to define a score allowing the selection of AS with the highest risk of LTBI.MethodsIn across-sectional study, AS seekers recently arrived in Vaud County, after screening for tuberculosis at the border were offered screening for LTBI with T-SPOT.TB and questionnaire on potentially risk factors. The factors associated with LTBI were analyzed by univariate and multivariate regression.ResultsAmong 393 adult AS, 98 (24.93%) had a positive IGRA response, five of them with active tuberculosis previously undetected. Six factors associated with LTBI were identified in multivariate analysis: origin, travel conditions, marital status, cough, age and prior TB exposure. Their combination leads to a robust LTBI predictive score.ConclusionsThe prevalence of LTBI and active tuberculosis in AS is high. A predictive score integrating six factors could identify the asylum seekers with the highest risk for LTBI.
Highlights
Screening and treatment of latent tuberculosis infection (LTBI) in asylum seekers (AS) may prevent future cases of tuberculosis
This study provided a realistic description of actual collective of asylum seekers arriving in Vaud county
This study highlights the factors associated with LTBI among asylum seekers entering Vaud County, Switzerland
Summary
Screening and treatment of latent tuberculosis infection (LTBI) in asylum seekers (AS) may prevent future cases of tuberculosis. Most of the asylum seekers entering in Switzerland lived in countries with higher incidence rate of tuberculosis than in Western Europe and have a high risk of latent tuberculosis infection (LTBI) [1]. A preventive treatment of infected but asymptomatic individuals lowers the risk of reactivation of latent infection and decreases the pool of future active tuberculosis in a population [3]. Those principles are the basis of screening protocols for the management of individuals exposed to patients with active tuberculosis. Screening for LTBI with tuberculin skin test (TST) was used during several years but was suspended after a study demonstrated the limited implications of a positive test result, the weak observance of the treatment for LTBI by physicians and asylum seekers with a positive TST [7]
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