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

被引：14
作者：
Ohd, Joanna Nederby [1 ,2 ]
Hergens, Maria-Pia [1 ,2 ,3 ]
Luksha, Yauheni [4 ]
Buxbaum, Charlotte [5 ]
Shedrawy, Jad [1 ]
Jonsson, Jerker [6 ]
Bruchfeld, Judith [3 ,4 ]
Lonnroth, Knut [1 ]
机构：
[1] Karolinska Inst, Dept Global Publ Hlth, Solnavagen 1, S-17177 Stockholm, Sweden
[2] Dept Communicable Dis Prevent & Control, Stockholm, Stockholm Regio, Sweden
[3] Karolinska Inst, Div Infect Dis, Dept Med Solna, Stockholm, Sweden
[4] Karolinska Univ Hosp Solna, Dept Infect Dis, Stockholm, Sweden
[5] Karolinska Univ Hosp Huddinge, Astrid Lindgren Childrens Hosp, Stockholm, Sweden
[6] Publ Hlth Agcy Sweden, Dept Publ Hlth Anal & Data Management, Unit Epidemiol Monitoring, Solna, Sweden
来源：
EUROPEAN RESPIRATORY JOURNAL | 2021年 / 57卷 / 03期
基金：
瑞典研究理事会;
关键词：
INFECTION; MIGRANTS;
D O I：
10.1183/13993003.02255-2020
中图分类号：
R56 [呼吸系及胸部疾病];
学科分类号：
摘要：
Introduction: 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. Method: 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. Results: 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. Conclusion: 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.
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页数：10
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