Department of Clinical Immunology and Rheumatology, Hannover Medical School, 30625 Hannover, Germany.
German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, 30625 Hannover, Germany.
Int J Environ Res Public Health. 2018 Jun 14;15(6):1263. doi: 10.3390/ijerph15061263.
In 2015, a high number of refugees with largely unknown health statuses immigrated to Western Europe. To improve caretaking strategies, we assessed the prevalence of latent tuberculosis infection (LTBI) in a refugee cohort.
Interferon-Gamma release assays (IGRA, Quantiferon) were performed in = 232 inhabitants of four German refugee centers in the summer of 2015.
Most refugees were young, male adults. Overall, IGRA testing was positive in 17.9% (95% CI = 13.2⁻23.5%) of subjects. Positivity rates increased with age (0% <18 years versus 46.2% >50 years). Age was the only factor significantly associated with a positive IGRA in multiple regression analysis including gender, C reactive protein, hemoglobin, leukocyte, and thrombocyte count and lymphocyte, monocyte, neutrophil, basophil, and eosinophil fraction. For one year change in age, the odds are expected to be 1.06 times larger, holding all other variables constant ( = 0.015).
Observed LTBI frequencies are lower than previously reported in similar refugee cohorts. However, as elderly people are at higher risk for developing active tuberculosis, the observed high rate of LTBI in senior refugees emphasizes the need for new policies on the detection and treatment regimens in this group.
2015 年,大量健康状况基本未知的难民涌入西欧。为了改善护理策略,我们评估了一个难民群体中潜伏性结核感染(LTBI)的流行率。
2015 年夏季,对德国四个难民中心的 = 232 名居民进行了干扰素 - γ释放试验(IGRA,QuantiFERON)。
大多数难民是年轻的成年男性。总体而言,IGRA 检测阳性率为 17.9%(95%CI=13.2⁻23.5%)。阳性率随年龄增加而升高(0%<18 岁与 46.2%>50 岁)。年龄是多因素回归分析中唯一与 IGRA 阳性显著相关的因素,包括性别、C 反应蛋白、血红蛋白、白细胞和血小板计数以及淋巴细胞、单核细胞、中性粒细胞、嗜碱性粒细胞和嗜酸性粒细胞比例。在其他所有变量保持不变的情况下,年龄每增加 1 岁,IGRA 阳性的几率预计会增加 1.06 倍( = 0.015)。
观察到的 LTBI 频率低于先前在类似难民群体中报告的频率。然而,由于老年人患活动性结核病的风险更高,观察到的高龄难民 LTBI 率较高强调了在该人群中检测和治疗方案方面需要制定新政策。