RESUMEN
BACKGROUND/AIM: Treatment of latently infected individuals at increased risk of reactivation is a cornerstone in tuberculosis control. Although asylum seekers without residence permit in Sweden are offered screening for both active tuberculosis and latent tuberculosis infection (LTBI), treatment for LTBI is often not initiated due to anticipated low rates of treatment completion. We aimed to compare completion rates for LTBI treatment between asylum seekers and other patients, and between asylum seekers with and without residence permit. METHODS: Data were collected retrospectively from tuberculosis clinic registers and medical records. For comparison of treatment completion rates, relative risks (RR) and confidence intervals (CI) were calculated. Predictors of completion were assessed by logistic regression multivariate analysis. RESULTS: Treatment completion was achieved in 506/606 subjects (83%). RR of non-completion for asylum seekers (n = 297) compared to other subjects (n = 309) was 1.13 (95% CI: 0.79-1.61; p = .51), and 0.91 (95% CI: 0.53-1.56; p = .72) for asylum seekers without residence permit (n = 217) compared to asylum seekers with residence permit (n = 80). Completion rates increased from 53% in 2008 to 92% in 2015-2016. The following factors were associated with completion: scheduled interpreter-assisted appointments throughout the course of therapy, shorter treatment duration (6 vs. 9 months), and being treated in connection with immunosuppressive therapy. CONCLUSION: Treatment completion rates were similar between asylum seekers and other subjects, supporting initiation of latent tuberculosis treatment in immigrants with recent arrival to low-endemic countries.
Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Tuberculosis Latente/tratamiento farmacológico , Refugiados/estadística & datos numéricos , Adolescente , Adulto , Antituberculosos/uso terapéutico , Niño , Preescolar , Femenino , Hospitales Universitarios , Humanos , Lactante , Recién Nacido , Tuberculosis Latente/diagnóstico , Masculino , Tamizaje Masivo/estadística & datos numéricos , Análisis Multivariante , Estudios Retrospectivos , Suecia , Adulto JovenAsunto(s)
Pulmón/fisiología , Tuberculosis Pulmonar/epidemiología , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/epidemiología , Índice de Masa Corporal , Estudios de Cohortes , Diabetes Mellitus/epidemiología , Femenino , Humanos , Incidencia , Pulmón/fisiopatología , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Pruebas de Función Respiratoria , Riesgo , Suecia/epidemiologíaRESUMEN
BACKGROUND AND OBJECTIVES: The transmission routes for GB virus-C (GBV-C)/hepatitis G virus (HGV) in blood donors unexposed to hepatitis C virus (HCV) are unknown. We performed a case-control study of risk factors for GBV-C/HGV exposure in blood donors. MATERIALS AND METHODS: After testing stored sera from 458 HCV-negative blood donors for GBV-C/HGV RNA and GBV-C/HGV E2 antibodies, 66 donors with GBV-C/HGV markers and 125 age- and gender-matched controls were interviewed regarding risk factors for viral transmission. RESULTS: Exposure to GBV-C/HGV was strongly associated with previous treatment for a sexually transmitted disease (odds ratio [OR] 4.6; 95% confidence interval [CI] 2.2-9.8), with multiple sexual partners (OR 2.9; 95% CI 1.4-5.7) and with a past history of endoscopy (OR 7.0; 95% CI 3.0-16.4). CONCLUSIONS: In blood donors with GBV-C/HGV markers, sexual contacts and medical procedures appear to be the main transmission routes.