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瑞士联邦庇护中心员工潜伏性结核感染监测

Surveillance of Employees of Swiss Federal Asylum Centres for Latent Tuberculosis Infection.

作者信息

Zellweger Jean-Pierre, Zellweger-Landry Ariane, Egger Jean-Marie, Koller-Doser Annette, Schmidt Axel Jeremias

机构信息

TB Competence Centre, Swiss Lung Association, Bern, Switzerland,

Unilabs Analytical Laboratory, Lausanne, Switzerland.

出版信息

Respiration. 2021;100(5):411-415. doi: 10.1159/000514110. Epub 2021 Mar 11.

Abstract

BACKGROUND

Asylum seekers in Switzerland have to register in federal asylum centres (FACs) before formal permission to enter the country. Some of them may have active tuberculosis (TB), exposing fellow refugees and employees.

OBJECTIVES

The aim of this study was to assess the risk of TB infection among employees of Swiss FACs.

METHODS

Between 2010 and 2018, a free interferon-gamma release assay (IGRA) was offered to all employees of 8 FACs, at employment and at yearly intervals. We defined latent TB infection as IGRA conversion from negative to positive. IGRA-positive employees were referred to a medical centre for further clinical follow-up.

RESULTS

1,427 tests were performed among 737 employees (54.6% male). 403 (55%) persons were tested only once; 330 (44.5%) were tested several times; for 4 (0.5%) persons, the number of IGRA tests is unknown. Twenty employees (2.7%) had a positive IGRA at baseline, 2 (0.6%) converted from negative to positive during follow-up, resulting in an incidence of 22/10,000 person-years. We observed no case of active TB among employees.

CONCLUSIONS

The prevalence of latent TB among employees to Swiss FACs and the risk of acquiring TB infection through work-related exposure are low. Yearly IGRA controls in the absence of documented TB exposure seem unnecessary.

摘要

背景

在瑞士,寻求庇护者在获得正式入境许可前必须在联邦庇护中心登记。其中一些人可能患有活动性结核病,会对其他难民和工作人员构成感染风险。

目的

本研究旨在评估瑞士联邦庇护中心工作人员感染结核病的风险。

方法

在2010年至2018年期间,为8个庇护中心的所有工作人员在入职时及之后每年提供一次免费的干扰素-γ释放试验(IGRA)。我们将潜伏性结核感染定义为IGRA结果由阴性转为阳性。IGRA结果呈阳性的工作人员被转介至医疗中心进行进一步的临床随访。

结果

对737名工作人员(54.6%为男性)进行了1427次检测。403人(55%)仅接受过一次检测;330人(44.5%)接受过多次检测;4人(0.5%)的IGRA检测次数不详。20名工作人员(2.7%)在基线时IGRA结果呈阳性,2人(0.6%)在随访期间由阴性转为阳性,发病率为22/10000人年。我们未观察到工作人员中有活动性结核病例。

结论

瑞士联邦庇护中心工作人员中潜伏性结核的患病率以及通过工作接触感染结核病的风险较低。在没有记录在案的结核暴露情况下,每年进行IGRA检测似乎没有必要。

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