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Yield of tuberculosis screening in asylum-seekers by country of origin: analysis of screening data in a German federal state (2002–2015)

Kayvan Bozorgmehr, Brigitte Joggerst, Ulrich Wagner, Christian Stock
European Respiratory Journal 2017 49: 1602327; DOI: 10.1183/13993003.02327-2016
Kayvan Bozorgmehr
1Dept of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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  • For correspondence: kayvan.bozorgmehr@med.uni-heidelberg.de
Brigitte Joggerst
2Public Health Authority, Pforzheim, Germany
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Ulrich Wagner
3Public Health Authority, Section for Disease Control, Karlsruhe, Germany
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Christian Stock
4Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Heidelberg, Germany
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Extract

Upon-entry screening for tuberculosis (TB) in immigrants plays a major role in national TB programmes of many low TB incidence countries [1]. The majority of European countries conduct routine screening for active TB in refugees and asylum-seekers using chest radiography alone or combined with other diagnostics [2]. Few countries, however, perform targeted screening among the heterogeneous group of asylum-seekers and refugees by using specific selection criteria [3]. Country of origin may serve as a selection criterion [4] to target and prioritise specific sub-groups and avoid “indiscriminate mass screening” [5]. Targeted screening would support front-line health workers to cope with the challenge of performing screening for TB in times of high immigration [6], e.g. in Germany when about 1 million new asylum-seekers were registered in 2015. Despite being desirable, so far a lack of empirical evidence precludes the (objective) determination of a suitable target group in asylum-seekers and refugees: only a few studies have reported the yield of screening for TB by country of origin [7].

Abstract

Yield of TB screening varies by country of origin; targeted approaches are needed to increase screening efficiency http://ow.ly/SuvZ30941Ej

Acknowledgements

The authors thank Ursula Paschmann (Public Health Services, Section for Disease Control, Landkreis Karlsruhe, Germany) for support in data collection and data management.

Authors' contributions: conceived the study: K. Bozorgmehr, B. Joggerst and C. Stock. Data collection: B. Joggerst and U. Wagner. Data analysis: C. Stock. First and last version of manuscript: Kayvan Bozorgmehr. All authors made important contributions to the study design, participated in drafting the article and revising it critically for important intellectual content, and gave final approval of the version to be submitted.

Footnotes

  • Support statement: This study was part of the BMBF-funded project RESPOND (“Improving Regional Health System Responses to the challenge of forced migration through tailored interventions for asylum-seekers and refugees”). The study received financial support by the Federal Ministry of Research and Education (BMBF) in the scope of the research programme “Strukturaufbau in der Versorgungsforschung” (grant number: FKZ 01GY1611). Funding information for this article has been deposited with the Crossref Funder Registry.

  • Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com

  • Received October 14, 2016.
  • Accepted December 26, 2016.
  • Copyright ©ERS 2017
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Yield of tuberculosis screening in asylum-seekers by country of origin: analysis of screening data in a German federal state (2002–2015)
Kayvan Bozorgmehr, Brigitte Joggerst, Ulrich Wagner, Christian Stock
European Respiratory Journal Apr 2017, 49 (4) 1602327; DOI: 10.1183/13993003.02327-2016

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Yield of tuberculosis screening in asylum-seekers by country of origin: analysis of screening data in a German federal state (2002–2015)
Kayvan Bozorgmehr, Brigitte Joggerst, Ulrich Wagner, Christian Stock
European Respiratory Journal Apr 2017, 49 (4) 1602327; DOI: 10.1183/13993003.02327-2016
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