Compliance with Tuberculosis Screening in Irregular Immigrants.

Tuberculosis (TB) is a serious public health problem in many regions of the world, especially in the poorest areas. For this reason, screening for active and latent forms must be considered when dealing with high-risk groups such as irregular immigrants in Western countries. We conducted a retrospective cohort study by recruiting subjects aged ≥15 years who underwent a tuberculin skin test at a dedicated National Health Service Centre in a northern Italian province between 1 January 2012 and 31 December 2013. These participants were followed up until 31 December 2016. We aimed at evaluating an experimental protocol for active and latent tuberculosis screening, focusing on patient compliance, feasibility, and capability to detect clinical forms of the disease. We enrolled 368 irregular immigrants, i.e., immigrants not having a valid residence permit and who were therefore not entitled to choose a general practitioner. In total, 90.22% of these completed all the steps for the screening of active TB, while 87.33% also undertook screening for the latent form of the disease. Homelessness, self-reported prostitution, female sex, and employment status adversely affected compliance. Chronic alcohol consumption was associated with increased risk of no beginning or interruption of the procedures. All of the five patients with active TB successfully completed the treatment. Overall, adherence to the screening program was high compared to other studies in immigrants, possibly owing to organizational factors such as the availability of cultural mediators, the network between the different health services, the presence of dedicated nursing staff and a free-of-charge service. In addition, selected vulnerable subgroups should be targeted using tailored screening and follow-up programs.

[The effect of a strategy to improve adherence of irregular non UE citizens to tuberculosis screening in a clinic of Reggio Emilia]. / L'effetto di una strategia per migliorare la compliance degli immigrati 'irregolari' allo screening per la tubercolosi in un ambulatorio di Reggio Emilia.

UNLABELLED: Latent tubercolar infection in irregular non EU-citizens in Italy is an important issue of public health. Aim of this paper is to describe the effects of a new organization of the Centre for the health of foreign families of Reggio Emilia. METHOD: A dedicated nurse, responsible of patients' screening and follow-up, in strict collaboration with a cultural interpreter were made available. Patients adherence to the screening was measured. RESULTS: On 177 eligible patients, 12 (6.7%) refused the Mantoux text. Over the 165 screened patients, 147 (89%) returned to the clinic after 3-4 days. Only 16 (10.8%) needed a phone reminder. Adherence to the screening improved remarkably compared to the previous year (89% vs 68%). CONCLUSIONS: A dedicated nurse and the improvement of communication may contribute to improve patients compliance.