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Free Content Tuberculosis screening among immigrants holding a hunger strike in churches

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SETTING: In January 2001, approximately 600 immigrants held a sit-down and hunger strike in several churches in Barcelona to force the Spanish government to comply with demands to regulate their immigration status. Following the diagnosis of a case of smear-positive pulmonary tuberculosis (TB) in one of the immigrants, we performed a large contact investigation.

OBJECTIVES: To describe contact investigation procedures used in this setting and to evaluate contact investigation results.

METHODS: Demographic variables were collected, and tuberculin skin tests (TST) and chest radiograph examinations were performed. Odds ratios (OR) with 95% confidence intervals (CI) were calculated and logistic regression was used for multivariate analyses.

RESULTS: A total of 541 TSTs were performed. Of these, 86% were read and 40.5% yielded a positive reaction with an induration >14 mm. In a multivariate analysis, the risk of presenting a TST induration >14 mm was found to be three times higher among those aged >35 years compared to those <24 years (OR 3.40; 95%CI 1.76–6.59), and for immigrants from Bangladesh (OR 3.14; 95%CI 1.16–6.10) and Pakistan (OR 2.04; 95%CI 1.11–3.73) compared to those from India. A total of 314 chest radiographs examinations were performed and three additional cases of TB were identified, yielding a TB prevalence of 0.7%.

CONCLUSIONS: By focusing efforts and conducting targeted TB screening in this high-risk population, it was possible to complete the intervention in only 3 days. A high prevalence of TB infection and TB disease was found.

Keywords: immigrants; tuberculin skin test; tuberculosis screening

Document Type: Regular Paper

Affiliations: 1: Department of Epidemiology, Agencia de Salut Pública, Barcelona, Spain; and Autonoma University of Barcelona, Barcelona, Spain 2: DAP Ciutat Vella, Institut Català de la Salut, Tuberculosis Investigation Unit of Barcelona, Barcelona, Spain 3: Department of Epidemiology, Agencia de Salut Pública, Barcelona, Spain

Publication date: 2003-12-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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