Abstract
Tuberculosis(TB) primarily occurs in the foreign-born in European countries, such as the UK, where increasing notifications and the high proportion of foreign-born cases has refocused attention on immigrant(new-entrant) screening. We investigated how UK Primary Care Organisations(PCOs) screen new-entrants and whether this differs according to TB burden in the PCOs(incidence less than or greater than 20 cases/100,000 p.a.,respectively).
Anonymous, 20-point-questionnaire sent to all 192 UK PCOs asking which new-entrants are screened, who is screened for active TB/latent TB infection(LTBI) and methods used. Descriptive analyses undertaken. Categorical responses compared using χ2-test.
177/192(92.2%) PCOs responded; all(177) undertook screening action in response to abnormal chest X-rays but only 107/177(60.4%) screened new-entrants for LTBI. Few new-entrants had active-TB diagnosed(median 0.0%,IQR 0.0–0.5%) but more were identified with LTBI(median 7.85%,IQR 4.30–13.50%). High-burden PCOs were significantly less likely to screen new-entrants for LTBI(OR:0.26,95% CI:0.12–0.54,p<0.0001). Among PCOs screening for LTBI, there was substantial deviation from national guidance in selection of new-entrant subgroups and screening method.
Considerable heterogeneity–and deviation from national guidance–exist throughout the UK new-entrant screening process with high-burden regions undertaking the least screening. Forming an accurate picture of current front-line practice will help to inform future development of European new-entrant screening policy.
- ERS
