Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
Università degli Studi di Modena e Reggio Emilia, Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Modena 41125, Italy.
Int J Environ Res Public Health. 2018 Dec 23;16(1):28. doi: 10.3390/ijerph16010028.
Tuberculosis (TB) is a serious public health problem in many regions of the world, especially in the poorest areas. For this reason, screening for active and latent forms must be considered when dealing with high-risk groups such as irregular immigrants in Western countries. We conducted a retrospective cohort study by recruiting subjects aged ≥15 years who underwent a tuberculin skin test at a dedicated National Health Service Centre in a northern Italian province between 1 January 2012 and 31 December 2013. These participants were followed up until 31 December 2016. We aimed at evaluating an experimental protocol for active and latent tuberculosis screening, focusing on patient compliance, feasibility, and capability to detect clinical forms of the disease. We enrolled 368 irregular immigrants, i.e., immigrants not having a valid residence permit and who were therefore not entitled to choose a general practitioner. In total, 90.22% of these completed all the steps for the screening of active TB, while 87.33% also undertook screening for the latent form of the disease. Homelessness, self-reported prostitution, female sex, and employment status adversely affected compliance. Chronic alcohol consumption was associated with increased risk of no beginning or interruption of the procedures. All of the five patients with active TB successfully completed the treatment. Overall, adherence to the screening program was high compared to other studies in immigrants, possibly owing to organizational factors such as the availability of cultural mediators, the network between the different health services, the presence of dedicated nursing staff and a free-of-charge service. In addition, selected vulnerable subgroups should be targeted using tailored screening and follow-up programs.
结核病（TB）是世界上许多地区，尤其是最贫困地区的严重公共卫生问题。出于这个原因，在处理西方国家的高危人群（如非正常移民）时，必须考虑主动和潜伏形式的筛查。我们通过招募在意大利北部一个省份的专门国家卫生服务中心接受结核菌素皮肤试验的年龄≥15 岁的受试者，进行了一项回顾性队列研究。这些参与者随访至 2016 年 12 月 31 日。我们旨在评估一种主动和潜伏结核病筛查的实验方案，重点是患者的依从性、可行性和发现疾病临床形式的能力。我们招募了 368 名非正常移民，即没有有效居留许可的移民，因此无权选择全科医生。这些人中，90.22%的人完成了主动结核病筛查的所有步骤，87.33%的人还进行了潜伏性结核病筛查。无家可归、自述卖淫、女性性别和就业状况对依从性产生了不利影响。慢性酒精消费与未开始或中断程序的风险增加有关。所有 5 例活动性结核病患者均成功完成了治疗。总体而言，与移民的其他研究相比，该筛查方案的依从性较高，这可能归因于组织因素，如文化调解员的可用性、不同卫生服务之间的网络、专门护理人员的存在和免费服务。此外，应使用量身定制的筛查和随访计划针对选定的弱势群体。
