Refugee Health, Marion County Public Health Department, Indianapolis, Indiana, USA.
Refugee Health, Marion County Public Health Department, Indianapolis, Indiana, USA.
Public Health. 2018 Jun;159:27-30. doi: 10.1016/j.puhe.2018.03.008. Epub 2018 Apr 24.
To determine, subsequent to the expansion of a county health department's refugee screening process from a one-step to a two-step process, the change in early loss to follow-up and time to initiation of treatment of new refugees with latent tuberculosis infection (LTBI).
Quasi-experimental, quantitative.
Review of patient medical records.
Among 384 refugees who met the case definition of LTBI without prior tuberculosis (TB) classification, the number of cases lost to early follow-up fell from 12.5% to 0% after expansion to a two-step screening process. The average interval between in-country arrival and initiation of LTBI treatment was shortened by 41.4%.
The addition of a second step to the refugee screening process was correlated with significant improvements in the county's success in tracking and treating cases of LTBI in refugees. Given the disproportionate importance of foreign-born cases of LTBI to the incidence of TB disease in low-incidence countries, these improvements could have a substantial impact on overall TB control, and the process described could serve as a model for other local health department refugee screening programs.
在县卫生部门的难民筛查流程从一步扩展到两步之后，确定新的潜伏性结核感染（LTBI）的难民中早期失访和开始治疗的时间的变化。
准实验，定量。
回顾患者病历。
在 384 名符合 LTBI 但无先前结核病（TB）分类的案例定义的难民中，在扩展到两步筛查流程后，早期失访的病例数从 12.5%降至 0%。从入境到开始 LTBI 治疗的平均间隔缩短了 41.4%。
在难民筛查流程中增加第二步与该县在追踪和治疗 LTBI 病例方面取得显著成功相关。鉴于外国出生的 LTBI 病例对低发病率国家结核病发病率的不成比例的重要性，这些改进可能对整体结核病控制产生重大影响，所描述的流程可以作为其他地方卫生部门难民筛查计划的模型。
