NDLI: Nationwide surveillance algorithms for tuberculosis among immigrant workers from highly endemic countries following pre-entry screening in Taiwan

Content Provider	Springer Nature : BioMed Central
Author	Kuan, Mei-Mei
Abstract	Background This cross-sectional study was retrospectively performed to assess the trend of tuberculosis (TB) among Taiwan’s immigrant workers from highly TB-endemic countries under an intervention of conducting a 4-round follow-up (at 0–3 days and 6, 18, and 30 months post-migration) screening program with initial chest X-ray (CXR) following an overseas, pre-entry normal CXR. Methods The immigrant workers with TB disease enrolled in the Taiwan TB registry database in 2011–2014 were analyzed and linked to an immigrant worker physical exam database to stratify TB case categories of actively screened or not for comparison. Results Following pre-entry screening for the admission of CXR-normal immigrant workers from highly endemic countries, the overall TB incidence of 70.6–128.6/100,000 person-years resulted either from a subsequent series of 4-round post-entry active screenings or misalliance algorithms, including passive diagnostics for the illness. Overall, the TB relative risk based on incidence in the immigrant working population was 2.2- to 5.5-fold greater than that among corresponding age Taiwanese, with 14.3% (15.5/100,000 person-years) sputum-smear-positive pulmonary TB (SS+ PTB), 74.2% (80.8/100,000 person-years) sputum-smear-negative (SS-) PTB, and 7.8% (8.5/100,000 person-years) only extra-pulmonary TB (EPTB). Regarding the clinical characteristics, 55.5% TB cases – identified through passive illness diagnostics vs. 44.5% TB cases actively identified through mandatory screenings, were higher in SS+ PTB (adjusted odds Ratio (aOR): 1.5, 95% CI: 1.1–2.0, P = 0.008), higher in SC+ PTB (aOR: 1.4, 95% CI: 1.1–1.7, P = 0.004), higher in concurrent extra-pulmonary TB (aOR: 8.9, CI: 4.5–7.4, P < 0.001), and higher in normal CXR TB (aOR: > 100, CI: 0- > 100, P = 0.908). The TB yields of 3rd- to 4th-round screenings were higher than those of 1st- and 2nd-round screenings and ranged from 52.6–65.3 cases per 100,000 screenings in 2013–2014. Conclusions The multiple post-entry TB screenings with initial CXR for high-risk immigrants could actively reduce TB transmission by finding SS- TB cases at early stages. The TB yields at post-entry 3rd- to 4th-round screenings might imply a persistent reactivation of latent TB. Adding more sensitive, economical screenings and preventive treatments for latent TB infection is a comprehensive approach for accelerating TB elimination.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-018-6029-x.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-018-6029-x
Journal	BMC Public Health
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2018-10-03
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health Pulmonary tuberculosis Immigrant worker Post-entry screening Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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