title: Tuberculosis screening among immigrants holding a hunger strike in churches.
abstract: METHODS
  In January 2001, approximately 600 immigrants held a sit-down and hunger strike in several churches in Barcelona to force the Spanish government to comply with demands to regulate their immigration status. Following the diagnosis of a case of smear-positive pulmonary tuberculosis (TB) in one of the immigrants, we performed a large contact investigation.
  
  
  OBJECTIVE
  To describe contact investigation procedures used in this setting and to evaluate contact investigation results.
  
  
  METHODS
  Demographic variables were collected, and tuberculin skin tests (TST) and chest radiograph examinations were performed. Odds ratios (OR) with 95% confidence intervals (CI) were calculated and logistic regression was used for multivariate analyses.
  
  
  RESULTS
  A total of 541 TSTs were performed. Of these, 86% were read and 40.5% yielded a positive reaction with an induration >14 mm. In a multivariate analysis, the risk of presenting a TST induration >14 mm was found to be three times higher among those aged >35 years compared to those <24 years (OR 3.40; 95%CI 1.76-6.59), and for immigrants from Bangladesh (OR 3.14; 95%CI 1.16-6.10) and Pakistan (OR 2.04; 95%CI 1.11-3.73) compared to those from India. A total of 314 chest radiographs examinations were performed and three additional cases of TB were identified, yielding a TB prevalence of 0.7%.
  
  
  CONCLUSIONS
  By focusing efforts and conducting targeted TB screening in this high-risk population, it was possible to complete the intervention in only 3 days. A high prevalence of TB infection and TB disease was found.
authors.affiliation: Department of Epidemiology, Agencia de Salut Pública, Barcelona, Spain. polalla@imsb.bcn.es
authors.forename: P
authors.initials: P
authors.lastname: García de Olalla
authors.forename: J A
authors.initials: JA
authors.lastname: Caylà
authors.forename: C
authors.initials: C
authors.lastname: Milá
authors.forename: J M
authors.initials: JM
authors.lastname: Jansà
authors.forename: I
authors.initials: I
authors.lastname: Badosa
authors.forename: A
authors.initials: A
authors.lastname: Ferrer
authors.forename: M
authors.initials: M
authors.lastname: Ros
authors.forename: J
authors.initials: J
authors.lastname: Gómez i Prat
authors.forename: J M
authors.initials: JM
authors.lastname: Armengou
authors.forename: E
authors.initials: E
authors.lastname: Alonso
authors.forename: J
authors.initials: J
authors.lastname: Alcaide
mesh_terms: D000293:Adolescent; D000328:Adult; D016358:Contact Tracing / Q000379:methods*; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011203:Poverty; D015397:Program Evaluation; D013030:Spain / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission*