Evaluation of the latent tuberculosis screening and treatment strategy for asylum seekers in Stockholm, Sweden 2015-2018: a record linkage study of the care cascade.
Journal
The European respiratory journal
ISSN: 1399-3003
Titre abrégé: Eur Respir J
Pays: England
ID NLM: 8803460
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
26
02
2020
accepted:
12
08
2020
pubmed:
29
8
2020
medline:
3
7
2021
entrez:
29
8
2020
Statut:
epublish
Résumé
About 90% of active tuberculosis (TB) cases in Sweden are foreign born and are mainly due to latent TB infection (LTBI) reactivation. The aim of this study was to assess the current migrant LTBI screening programme with regards to test results and completion of the care cascade. A retrospective cohort of all 14173 individuals attending a health examination was established for the Stockholm Region 2015-2018 through record-linkage of data extracted from the Swedish Migration Authority and medical records. Screening results, referrals to specialist care and treatment initiation were ascertained through automated data extraction for the entire cohort. Detailed cascade steps, including treatment completion, were analysed through manual data extraction for a subsample of all persons referred to specialist care in the period 2016-2017. Of 5470 patients screened with an interferon-gamma release assay (IGRA), 1364 (25%) were positive, of whom 358 (26%) initiated LTBI treatment. An increased trend in IGRA-positivity was seen for increased age and TB-incidence in country of origin. Among the IGRA positive patients, 604 (44%) were referred to specialist care. Lower age was the main referral predictor. In the subsample of 443 patients referred to specialist care in 2016-2017, 386 (87%) were invited, of whom 366 (95%) attended. Of 251 patients (69%) recommended for LTBI treatment, 244 (97%) started such treatment and of those 221 (91%) completed it. The low attrition in patient-dependent cascade steps shows that the voluntary approach works well. Low LTBI treatment attainment is due to the current conservative local treatment policy, which means the vast majority are IGRA-tested without an intention to treat for LTBI.
Identifiants
pubmed: 32855227
pii: 13993003.02255-2020
doi: 10.1183/13993003.02255-2020
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright ©ERS 2021.
Déclaration de conflit d'intérêts
Conflict of interest: J. Nederby Öhd has nothing to disclose. Conflict of interest: M-P. Hergens has nothing to disclose. Conflict of interest: Y. Luksha has nothing to disclose. Conflict of interest: C. Buxbaum has nothing to disclose. Conflict of interest: J. Shedrawy has nothing to disclose. Conflict of interest: J. Jonsson has nothing to disclose. Conflict of interest: J. Bruchfeld has nothing to disclose. Conflict of interest: K. Lönnroth has nothing to disclose.