Tuberculosis case finding based on symptom screening among immigrants, refugees and asylum seekers in Rome.
BACKGROUND
In Italy the proportion of cases of tuberculosis in persons originating from high-prevalence countries has been increasing in the last decade. We designed a study to assess adherence to and yield of a tuberculosis screening programme based on symptom screening conducted at primary care centres for regular and irregular immigrants and refugees/asylum seekers.


METHODS
Presence of symptoms suggestive of active tuberculosis was investigated by verbal screening in migrants presenting for any medical condition to 3 free primary care centres in the province of Rome. Individuals reporting at least one symptom were referred to a tuberculosis clinic for diagnostic workup.


RESULTS
Among 2142 migrants enrolled, 254 (11.9%) reported at least one symptom suggestive of active tuberculosis and 176 were referred to the tuberculosis clinic. Of them, 80 (45.4%) did not present for diagnostic evaluation. Tuberculosis was diagnosed in 7 individuals representing 0.33% of those screened and 7.3% of those evaluated for tuberculosis.


CONCLUSIONS
The overall yield of this intervention was in the range reported for other tuberculosis screening programmes for migrants, although we recorded an unsatisfactory adherence to diagnostic workup. Possible advantages of this intervention include low cost and reduced burden of medical procedures for the screened population. Further evaluation of this approach appears to be warranted.
Clinical Epidemiology Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases, IRCCS L, Spallanzani, Rome, Italy. enrico.girardi@inmi.it.
Monica
M
Sañé Schepisi
Gina
G
Gualano
Claudia
C
Fellus
Nazario
N
Bevilacqua
Marco
M
Vecchi
Pierluca
P
Piselli
Giuliana
G
Battagin
Giulia
G
Silvestrini
Andrea
A
Attanasio
Alberto
A
Vela
Giorgia
G
Rocca
Alessandro
A
Rinaldi
Pietro
P
Benedetti
Salvatore
S
Geraci
Francesco Nicola
FN
Lauria
Enrico
E
Girardi
D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015995:Prevalence; D011314:Preventive Health Services; D012036:Refugees; D012384:Rome / Q000453:epidemiology; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control