Health Sciences unit, Faculty of Social Sciences, Tampere University, P.O. Box 30, FI-00271, Helsinki, Finland.
Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
BMC Public Health. 2020 Jun 19;20(1):969. doi: 10.1186/s12889-020-09122-5.
In Finland, asylum seekers from countries with high tuberculosis (TB) incidence (> 50/100,000 population/year) and those coming from a refugee camp or conflict area are eligible for TB screening. The aim of this study was to characterise the TB cases diagnosed during screening and estimate the yield of TB screening at the reception centres among asylum seekers, who arrived in Finland during 2015-2016.
Voluntary screening conducted at reception centres included an interview and a chest X-ray. Data on TB screening and health status of asylum seekers was obtained from the reception centres' national health register (HRS). To identify confirmed TB cases, the National Infectious Disease Register (NIDR) data of foreign-born cases during 2015-2016 were linked with HRS data. TB screening yield was defined as the percentage of TB cases identified among screened asylum seekers, stratified by country of origin.
During 2015-2016, a total of 38,134 asylum applications were received (57% were from Iraq, 16% from Afghanistan and 6% from Somalia) and 25,048 chest x-rays were performed. A total of 96 TB cases were reported to the NIDR among asylum seekers in 2015-2016; 94 (98%) of them had been screened. Screening identified 48 (50%) cases: 83% were male, 56% aged 18-34 years, 42% from Somalia, 27% from Afghanistan and 13% from Iraq. Furthermore, 92% had pulmonary TB, 61% were culture-confirmed and 44% asymptomatic. TB screening yield was 0.19% (48/25048) (95%CI, 0.14-0.25%) and it varied between 0 and 0.83% stratified by country of origin. Number needed to screen was 522.
TB screening yield was higher as compared with data reported from other European countries conducting active screening among asylum seekers. Half of the TB cases among asylum seekers were first suspected in screening; 44% were asymptomatic. TB yield varied widely between asylum seekers from different geographic areas.
在芬兰，来自结核病发病率较高的国家（>50/100,000 人/年）的寻求庇护者和来自难民收容所或冲突地区的寻求庇护者有资格接受结核病筛查。本研究的目的是描述在筛查期间诊断的结核病病例，并估计 2015-2016 年期间抵达芬兰的寻求庇护者在接待中心进行结核病筛查的效果。
在接待中心进行的自愿筛查包括访谈和胸部 X 光检查。从接待中心的国家健康登记处（HRS）获得有关寻求庇护者结核病筛查和健康状况的数据。为了确定确诊的结核病病例，将 2015-2016 年期间外国出生病例的国家传染病登记处（NIDR）数据与 HRS 数据进行关联。将结核病筛查率定义为在接受筛查的寻求庇护者中发现的结核病病例的百分比，按原籍国进行分层。
2015-2016 年期间，共收到 38134 份庇护申请（57%来自伊拉克，16%来自阿富汗，6%来自索马里），进行了 25048 次胸部 X 光检查。2015-2016 年期间，向 NIDR 报告了 96 例寻求庇护者中的结核病病例；其中 94 例（98%）接受了筛查。筛查发现 48 例（50%）病例：83%为男性，56%年龄在 18-34 岁之间，42%来自索马里，27%来自阿富汗，13%来自伊拉克。此外，92%患有肺结核，61%经培养证实，44%无症状。结核病筛查率为 0.19%（48/25048）（95%CI，0.14-0.25%），按原籍国分层，其范围在 0 到 0.83%之间。需要筛查的人数为 522 人。
与在接待寻求庇护者的其他欧洲国家进行主动筛查的报告数据相比，结核病筛查率较高。寻求庇护者中一半的结核病病例是在筛查中首次怀疑的；44%无症状。来自不同地理区域的寻求庇护者之间的结核病发病率差异很大。
