Bozorgmehr Kayvan, Razum Oliver, Saure Daniel, Joggerst Brigitte, Szecsenyi Joachim, Stock Christian
Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.
Euro Surveill. 2017 Mar 23;22(12). doi: 10.2807/1560-7917.ES.2017.22.12.30491.
All asylum seekers in Germany undergo upon-entry screening for tuberculosis TB, but comprehensive evidence on the yield is lacking. We compared the national estimates with the international literature in a systematic review and meta-analysis of studies reporting the yield of TB, defined as the fraction of active TB cases detected among asylum seekers screened in Germany upon entry. We searched 11 national and international databases for empirical studies and the internet for grey literature published in English or German without restrictions on publication time. Among 1,253 screened articles, we identified six articles reporting the yield of active TB based on German data, ranging from 0.72 (95% confidence interval (CI): 0.45-1.10) to 6.41 (95% CI: 4.19-9.37) per 1,000 asylum seekers. The pooled estimate across all studies was 3.47 (95% CI: 1.78-5.73; I = 94.9%; p < 0.0001) per 1,000 asylum seekers. This estimate was in line with international evidence (I = 0%; p for heterogeneity 0.55). The meta-analysis of available international estimates resulted in a pooled yield of 3.04 (95% CI: 2.24-3.96) per 1,000. This study provides an estimate across several German federal states for the yield of TB screening in asylum seekers. Further research is needed to develop more targeted screening programmes.
德国所有寻求庇护者在入境时都要接受结核病（TB）筛查，但关于筛查结果的全面证据尚缺。我们在一项系统综述和荟萃分析中，将全国性估计数据与国际文献进行了比较，该分析纳入了报告结核病筛查结果的研究，结核病筛查结果定义为在德国入境时接受筛查的寻求庇护者中检测出的活动性结核病例的比例。我们检索了11个国家和国际数据库以查找实证研究，并在互联网上搜索了以英文或德文发表的灰色文献，对发表时间没有限制。在1253篇筛选出的文章中，我们确定了6篇基于德国数据报告活动性结核筛查结果的文章，每1000名寻求庇护者中，筛查结果范围从0.72（95%置信区间（CI）：0.45 - 1.10）到6.41（95%CI：4.19 - 9.37）。所有研究的合并估计值为每1000名寻求庇护者3.47（95%CI：1.78 - 5.73；I² = 94.9%；p < 0.0001）。这一估计值与国际证据相符（I² = 0%；异质性p值为0.55）。对现有国际估计值进行的荟萃分析得出的合并筛查结果为每1000人中有3.04（95%CI：2.24 - 3.96）。本研究提供了德国几个联邦州寻求庇护者结核病筛查结果的估计值。还需要进一步研究以制定更具针对性的筛查方案。
