Description of the largest cluster of tuberculosis notified in Norway 1997–2011: is the Norwegian tuberculosis control programme serving its purpose for high risk groups?

BMC Public Health

Research Article

Turid Mannsåker¹  Karin Rønning¹  Ulf R Dahle¹  Katrine Borgen¹  Bernardo R Guzman Herrador² 

[1] Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway;Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway;European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden;

关键词: Tuberculosis;    Control programme;    Cluster;    Elimination;   

DOI  :  10.1186/s12889-015-1701-x

 received in 2014-09-19, accepted in 2015-03-27,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundApproximately 90% of new tuberculosis (TB) cases notified in Norway are asylum seekers and other immigrants from high-incidence countries. Asylum seekers are screened upon arrival at the National Immigration Centre. Other immigrants receive a letter from the Municipal Health Services requesting that they present for screening in their municipality of residence. In order to identify potential areas where the TB control programme could be better adapted for these groups, we studied the largest cluster of TB cases (“cluster X”) notified in Norway until 2011.MethodsCases were defined as TB notifications reported to MSIS between January 1997 and December 2011 with identical IS6110 RFLP assigned to cluster X. We described the cases in cluster X by using data from the Norwegian Surveillance System for Communicable Diseases (MSIS). Missing or incomplete information in MSIS was obtained from the National Reception Centre, Oslo University Hospital and Municipal Health services.ResultsOf a total of 44 individuals meeting the case definition, 36 originated from Somalia and eight from other high-incidence countries. Twenty nine were asylum seekers and 15 were other immigrants. Upon arrival, 18/44 had been diagnosed with latent TB infection (LTBI), 9/44 tested negative for LTBI and 4/44 had been diagnosed with active TB. Results of TB-screening upon arrival were not available for the remaining 13/44 (one asylum seeker and 12 other immigrants). Five of the 12 other immigrants had still not been screened for TB after staying one year or longer in Norway.ConclusionsMost cases in cluster X with available results of TB-screening were already infected at arrival, indicating that their disease could be due to endogenous reactivation, rather than recent transmission after arrival to Norway. TB-status upon arrival was unknown for many of the other immigrants due to lack of initial screening. The reasons why conduction of the initial screening among other immigrants is failing should be explored and methods to simplify the TB screening at arrival should be implemented.

【 授权许可】

CC BY   
© Guzman Herrador et al.; licensee BioMed Central. 2015