Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
Scand J Public Health. 2010 May;38(3):275-82. doi: 10.1177/1403494809353823. Epub 2009 Nov 13.
Asylum seekers are screened for tuberculosis at entry to Norway. We aimed to assess follow-up of screening results at different healthcare levels in relation to demographics, screening results and organizational factors, and how this influenced treatment of latent tuberculosis.
All asylum seekers >or=18 years with a Mantoux test >or=6 mm or positive x-ray findings who arrived at the National Reception Centre from January 2005 to June 2006, were included. Data were collected from public health authorities in the municipality where the asylum seekers had moved, and from internists in case they had been referred to a specialist. Specialists are responsible for treating latent tuberculosis. Individual subjects were matched with the National Tuberculosis Register to which everybody who had started treatment for latent tuberculosis was reported.
Of 4,643 asylum seekers, 2,237 fulfilled the inclusion criteria. By May 2008, 30 persons had started treatment for latent TB, a median of 17 months (range 3-36) after arrival. A Mantoux test >or=15 mm on arrival was significantly associated with treatment. Demographic factors influenced follow-up in primary healthcare while screening results did not. Referral to specialist was related to screening results. Several specialists were reluctant to diagnose and treat latent tuberculosis and to treat persons without a permanent visa in particular.
Just 1% of the study group received treatment for latent tuberculosis and with a long time delay. The reason for this may be organizational factors affecting follow-up and referral and specialists not following current guidelines.
在进入挪威时，寻求庇护者会接受结核病筛查。我们旨在评估不同医疗保健水平对筛查结果的随访情况，包括与人口统计学、筛查结果和组织因素的关系，以及这如何影响潜伏性结核病的治疗。
所有年龄在 18 岁及以上、曼托试验结果>6 毫米或 X 光检查阳性的寻求庇护者，自 2005 年 1 月至 2006 年 6 月，抵达国家接待中心后，都被纳入研究。数据从公共卫生当局收集，这些当局在寻求庇护者迁移的城市/镇中，以及在他们被转介到专家的情况下，从内科医生那里收集数据。专家负责治疗潜伏性结核病。每个个体都与国家结核病登记处相匹配，所有开始治疗潜伏性结核病的人都在该登记处报告。
在 4643 名寻求庇护者中，有 2237 人符合纳入标准。截至 2008 年 5 月，已有 30 人开始接受潜伏性结核病治疗，中位数为抵达后 17 个月（范围 3-36）。抵达时的曼托试验结果>15 毫米与治疗显著相关。人口统计学因素影响初级保健中的随访，而筛查结果没有。转介到专家与筛查结果有关。一些专家不愿意诊断和治疗潜伏性结核病，特别是对没有永久签证的人。
研究组中只有 1%的人接受了潜伏性结核病治疗，而且时间延迟很长。原因可能是影响随访和转介的组织因素以及专家不遵循当前指南。
