Groupe hospitalier Sud Ile-de-France, Department of Public Health, Melun, Department of Social Epidemiology, Unité mixte de Recherche (UMR) 1136, Institut Pierre Louis d´Épidémiologie et de Santé Publique, Institut national de la Santé et de la Recherche médicale (INSERM), Sorbonne Université, Paris.
National network of TB control centres, Strasbourg Hospital, Strasbourg, France.
Int J Tuberc Lung Dis. 2021 Nov 1;25(11):903-910. doi: 10.5588/ijtld.21.0231.
Migrants to Europe face a disproportionate burden of infections, including TB, yet little is known about the approach taken by primary and secondary care providers to screening and treatment. We therefore explored policy and practice relating to screening of active TB and latent TB infection (LTBI) in France. We conducted an online national survey of French primary and secondary care physicians regarding their practices in relation to TB/LTBI screening among migrants. 367 physicians responded to the questionnaire among which 195 (53.1%) were primary care physicians, 126 (34.3%) were TB specialists in secondary care, and 46 (12.5%) other physicians; 303 (85.5%) were involved daily in the care of migrants. Most respondents recommended systematic TB screening with chest X-ray for migrants from medium and high-incidence countries (71.9%). Primary care physicians were less likely to offer screening than physicians in other settings (aOR 0.21, 95% CI 0.09-0.48). 220 (61.8%) offered LTBI screening for children (<15 years) and 34.0% for all migrants from high incidence countries. Improving awareness on TB screening is a critical next step to improve health outcomes in migrant groups and meet regional targets for tackling TB.
移民到欧洲面临着不成比例的感染负担,包括结核病,但对于初级和二级保健提供者在筛查和治疗方面采取的方法知之甚少。因此,我们探讨了法国与主动结核病和潜伏性结核病感染(LTBI)筛查相关的政策和实践。我们对法国初级和二级保健医生进行了一项关于其在移民中进行结核病/LTBI 筛查的实践的在线全国调查。367 名医生对问卷做出了回应,其中 195 名(53.1%)是初级保健医生,126 名(34.3%)是二级保健中的结核病专家,46 名(12.5%)是其他医生;303 名(85.5%)每天都参与移民的护理。大多数受访者建议对来自中高发病国家的移民进行系统的结核病筛查,包括胸部 X 光检查(71.9%)。初级保健医生提供筛查的可能性低于其他医疗机构的医生(优势比 0.21,95%置信区间 0.09-0.48)。220 名医生(61.8%)为儿童(<15 岁)提供 LTBI 筛查,34.0%为所有来自高发病国家的移民提供 LTBI 筛查。提高对结核病筛查的认识是改善移民群体健康结果和实现区域结核病防治目标的关键下一步。