Screening for pulmonary tuberculosis among immigrants: estimated effect on severity of disease and duration of infectiousness.
OBJECTIVE
To estimate the effect of tuberculosis screening among recent immigrants on the severity of disease at diagnosis and on the duration of the infectious period.


METHODS
Comparison of pulmonary tuberculosis cases among immigrants detected through screening with those detected passively, using information from the Netherlands Tuberculosis Register.


METHODS
Immigrants from highly endemic countries diagnosed with culture-positive pulmonary tuberculosis within 30 months after arrival in The Netherlands, 1993 through 1998.


METHODS
Severity of disease (smear-positive disease, hospitalisation, case fatality) and duration of symptomatic period.


RESULTS
A total of 882 bacteriologically confirmed tuberculosis patients from highly endemic countries had been in The Netherlands less than 30 months, and were detected through screening (454), or passively (368). Compared with patients detected passively, patients found through screening were less often sputum smear-positive (OR 0.5, 95%CI 0.3-0.8) and less often hospitalised (OR 0.2, 95%CI 0.1-0.2). Those detected through screening had a shorter symptomatic period. Screening is estimated to have reduced the infectious period by approximately 33%.


CONCLUSIONS
The screening programme detected cases earlier, resulting in fewer hospital admissions, shorter duration of symptoms and therefore probably reduced tuberculosis transmission.
Verver
S
S
Royal Netherlands Tuberculosis Association, The Hague.
Bwire
R
R
Borgdorff
M W
MW
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009426:Netherlands; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control*