Screening and treatment for tuberculosis in a cohort of unaccompanied minor refugees in Berlin, Germany

• DOI: 10.1371/journal.pone.0216234
• Publication Date: 2019-05-21T17:49:29Z
• Authors: Stephanie Thee; Renate Krüger; Horst von Bernuth; Christian Meisel; Uwe Kölsch; Valerie Kirchberger; Cornelia Feiterna...
• Keywords: Male; Adolescent; Science; 610; Chemoprevention; 03 medical and health sciences; 0302 clinical medicine; Latent Tuberculosis; Germany; Isoniazid; Humans; Mass Screening; Tuberculosis; adolescents; Refugees; IGRA; Q; R; Hepatitis B; refugees; 3. Good health; Berlin; Minors; minors; Medicine; Female; Rifampin; 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit; Research Article; interferon-γ-release-assay

In 2015, 4062 unaccompanied minor refugees were registered in Berlin, Germany. According to national policies, basic clinical examination and tuberculosis (TB) screening is a prerequisite admission permanent accommodation schooling for every refugee. This article evaluates the use of an interferon-γ-release-assay (IGRA) during initial TB 970 refugees.IGRA test obtained 301 (31.0%) adolescents not previously screened TB. Positive IGRA results 13.9% (42/301). Most 42 IGRA-positive originated from Afghanistan or Syria (n?20 10 respectively). Two lost follow-up, 2 diagnosed with remaining 38 latent infection (LTBI). Demographic features 40 patients positive result as follows: 39 male, median age 16.8 years (IQR 16.0-17.2y), none meeting underweight criteria (median BMI 21.3kg/m2). On chest X-ray 2/40 participants had signs active TB, while disease was excluded diagnosis (LTBI) made. Active hepatitis B-co-infection 3/38 patients. All LTBI received Isoniazid Rifampicin 3 months without occurrence severe adverse events. The most frequently observed side effect transient upper abdominal pain (n = 5). Asymptomatic elevation liver transaminases seen 29 completed treatment no at end chemoprevention 9 follow up.Screening feasible our setting relatively high rate detected. Chemopreventive tolerated well regardless underlying hepatitis-B-status. Minor migrating Germany should be infection, instead only, background incidence.