The Ohio State University College of Public Health, Columbus, Ohio 43210, USA.
Int J Tuberc Lung Dis. 2013 Mar;17(3):320-5. doi: 10.5588/ijtld.12.0439.
A resettlement medical screening program that refers refugees with a positive tuberculin skin test (TST) to a public health tuberculosis (TB) clinic for evaluation for latent tuberculosis infection (LTBI).
To identify the proportion of refugees that were TST-positive, how many attended after referral for medical evaluation, what characteristics influenced follow-up, and whether programmatic changes would increase follow-up rates.
Refugee characteristics and follow-up information were extracted from the resettlement medical records of 224 adult refugees screened in Columbus, Franklin County, Ohio, in 2008. Programmatic modifications in the referral system were implemented in December 2010.
Of 224 refugees screened, 115 (51%) had a TST induration ≥ 5 mm, 113 (98.3%) were referred and 60 (53.1%) attended the Columbus Public Health (CPH) TB clinic for evaluation. Resettling from East Asia (Myanmar, Viet Nam; OR 12.48, 95%CI 2.32-67.06) and TST induration size ≥ 10 mm (OR 9.38, 95%CI 1.41-62.26) were significantly associated with follow-up at the CPH. Implementation of scheduled appointments, telephone reminders and transportation arrangements increased follow-up to 93.5%.
Collaborative strategies can improve follow-up rates of TST-positive refugees during resettlement medical screening, facilitate LTBI treatment and prevent the development of active TB.
重新安置医疗筛查计划将结核菌素皮肤试验（TST）阳性的难民转介到公共卫生结核病（TB）诊所，以评估潜伏性结核感染（LTBI）。
确定 TST 阳性难民的比例、有多少人在转介进行医学评估后就诊、哪些特征会影响随访，以及计划变更是否会提高随访率。
从 2008 年在俄亥俄州富兰克林县哥伦布市接受筛查的 224 名成年难民的重新安置医疗记录中提取难民特征和随访信息。2010 年 12 月对转诊系统进行了计划变更。
在 224 名接受筛查的难民中，有 115 名（51%）的 TST 硬结≥5 毫米，113 名（98.3%）被转介，60 名（53.1%）前往哥伦布公共卫生（CPH）TB 诊所进行评估。从东亚（缅甸、越南；OR12.48，95%CI2.32-67.06）重新安置和 TST 硬结大小≥10 毫米（OR9.38，95%CI1.41-62.26）与 CPH 的随访显著相关。实施预约、电话提醒和交通安排可将随访率提高到 93.5%。
协作策略可以提高重新安置医疗筛查期间 TST 阳性难民的随访率，促进 LTBI 的治疗，并预防活动性结核病的发生。
