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Perez-Porcuna TM, Noguera-Julian A, Riera-Bosch MT, Macià-Rieradevall E, Santos-Santiago J, Rifà Pujol MÀ, Eril M, Aulet-Molist L, Padilla-Esteba E, Tórtola MT, Gómez i Prat J, Vilamala Bastarras A, Rebull-Fatsini JS, Papaleo A, Rius-Gordillo N, Gonçalves AQ, Naranjo-Orihuela À, Urgelles M, García-Lerín MG, Jimenez-Lladser G, Lorenzo-Pino B, Giuliano-Cuello MA, Pascual-Sánchez MT, Marco-García M, Abellana R, Espiau M, Altet-Gómez MN, Orcau-Palau A, Caylà JA, Soriano-Arandes A. Tuberculosis among children visiting friends & relatives. J Travel Med 2024; 31:taae037. [PMID: 38438137 PMCID: PMC11298048 DOI: 10.1093/jtm/taae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/15/2024] [Accepted: 02/26/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Most paediatric tuberculosis (TB) cases in low-TB-incidence countries involve children born to migrant families. This may be partially explained by trips to their countries of origin for visiting friends and relatives (VFR). We aimed to estimate the risk of latent TB infection (LTBI) and TB in children VFR. METHODS We conducted a prospective multicentric observational study in Catalonia (Spain) from June 2017 to December 2019. We enrolled children aged < 15 years with a negative tuberculin skin test (TST) at baseline and at least one parent from a high-TB-incidence country, and who had travelled to their parent's birth country for ≥21 days. TST and QuantiFERON-TB Gold Plus (QFT-Plus) were performed within 8-12 weeks post-return. LTBI was defined as a TST ≥5 mm and/or a positive QFT-Plus. RESULTS Five hundred children completed the study, equivalent to 78.2 person-years of follow-up (PYFU). Thirteen children (2.6%) were diagnosed with LTBI (16.6/per100 PYFU, 95%CI = 8.8-28.5), including two cases (0.4%) of TB (2.5/per100 PYFU, 95%CI = 0.3-9.3). LTBI incidence rates remained high after excluding BCG-vaccinated children (9.7/per100 PYFU, 95%CI = 3.9-20.0). Household tobacco smoke exposure was associated with LTBI (aOR = 3.9, 95%CI = 1.1-13.3). CONCLUSIONS The risk of LTBI in children VFR in high-TB-incidence countries may equal, or perhaps even exceed, the infection risk of the native population. The primary associated risk factor was the presence of smokers in the household. Furthermore, the incidence rate of active TB largely surpassed that of the countries visited. Children VFR in high-TB-incidence countries should be targeted for diagnostic and preventive interventions.
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Affiliation(s)
- Tomas M Perez-Porcuna
- TB Pediatric Unit, Research Foundation of Primary Health and Mútua Terassa University Hospital, Mútua Terrassa, Terrassa, Catalunya 08221, Spain
| | - Antoni Noguera-Julian
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Servei de Malalties Infeccioses, Institut de Recerca Pediàtrica Sant Joan de Déu, Barcelona 08950, Spain
| | | | | | - José Santos-Santiago
- Salut International i Malalties Transmisibles Drassanes, Institut Català de la Salut, Barcelona 08001, Spain
| | | | - Maria Eril
- EAP La Vall del Ges, Institut Català de la Salut, Barcelona 08007, Spain
| | | | | | - Maria Teresa Tórtola
- Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona 08035, Barcelona
| | - Jordi Gómez i Prat
- Public Health and Community Team (eSPiC), Unit of Tropical Medicine and International Health Drassanes-Vall d'Hebron (UTMIHD-VH), PROSICS, Barcelona 08028, Spain
| | - Anna Vilamala Bastarras
- Hospital Universitari de Vic, Multidisciplinary Inflammation Research group (MIRG), Barcelona 08500, Spain
| | | | - Andrea Papaleo
- CAP Magoria, Institut Català de la Salut, Barcelona 08014, Spain
| | - Neus Rius-Gordillo
- Servei de Pediatria, Hospital Universitari Sant Joan de Reus, Reus 43204, Spain
| | - Alessandra Q Gonçalves
- Unitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Tortosa 08007, Spain
| | | | - Marta Urgelles
- CAP Terrassa Sud, Fundació Assistencial Mútua Terrassa, Terrassa 08221, Spain
| | | | | | - Beatriz Lorenzo-Pino
- CAP Rubí Mútua Terrassa, Fundació Assistencial Mútua Terrassa, Terrassa 08221, Spain
| | | | | | | | - Rosa Abellana
- Departament de Fonaments Clínics. Unitat de Bioestadística. Universitat de Barcelona, Barcelona 08007, Spain
| | - Maria Espiau
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Children's Hospital Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia 08035, Spain
| | | | | | - Joan A Caylà
- Barcelona Tuberculosis Research Unit Foundation, Barcelona 08036, Spain
| | - Antoni Soriano-Arandes
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Children's Hospital Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia 08035, Spain
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Nieto Morales ML, Linares Bello CC, El Khatib Ghzal Y, Benítez Rivero S, Fernandez Del Castillo Ascanio M, Souweileh Arencibia C. The pathologies of migrants who travel by boat documented on imaging. RADIOLOGIA 2024; 66:366-373. [PMID: 39089796 DOI: 10.1016/j.rxeng.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/03/2024] [Indexed: 08/04/2024]
Abstract
The migration phenomenon is increasingly common worldwide. It is essential for radiologists to be aware of the endemic diseases of the migrant's country as well as the characteristics of the journey to be able to understand and interpret radiological findings when admitted to our centre. This article aims to use imaging from our centre to describe the most common pathologies that migrant patients present with after long journeys by boat.
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Affiliation(s)
- M L Nieto Morales
- Radiodiagnóstico, Complejo Hospitalario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain.
| | - C C Linares Bello
- Radiodiagnóstico, Complejo Hospitalario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain
| | - Y El Khatib Ghzal
- Radiodiagnóstico, Complejo Hospitalario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain
| | - S Benítez Rivero
- Radiodiagnóstico, Complejo Hospitalario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain
| | | | - C Souweileh Arencibia
- Radiodiagnóstico, Complejo Hospitalario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain
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3
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Puyana Ortiz JD, Garcés Rodríguez AC, Aznar ML, Espinosa Pereiro J, Sánchez-Montalvá A, Martínez-Campreciós J, Saborit N, Rodrigo-Pendás JÁ, García Salgado G, Broto Cortes C, Delcor NS, Oliveira I, Treviño Maruri B, Ciruelo DP, Salvador F, Bosch-Nicolau P, Torrecilla-Martínez I, Zules-Oña R, Tórtola Fernández MT, Molina I. Adherence and Toxicity during the Treatment of Latent Tuberculous Infection in a Referral Center in Spain. Trop Med Infect Dis 2023; 8:373. [PMID: 37505669 PMCID: PMC10383852 DOI: 10.3390/tropicalmed8070373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023] Open
Abstract
The screening and treatment of latent tuberculosis infection (LTBI) in countries with a low incidence of TB is a key strategy for the elimination of tuberculosis (TB). However, treatment can result in adverse events (AEs) and have poor adherence. This study aimed to describe treatment outcomes and AEs for LTBI patients at two departments in Vall d'Hebron University Hospital in Barcelona, Spain. A retrospective study was conducted on all persons treated for LTBI between January 2018 and December 2020. Variables collected included demographics, the reason for LTBI screening and treatment initiation, AEs related to treatment, and treatment outcome. Out of 261 persons who initiated LTBI treatment, 145 (55.6%) were men, with a median age of 42.1 years. The indications for LTBI screening were household contact of a TB case in 96 (36.8%) persons, immunosuppressive treatment in 84 (32.2%), and recently arrived migrants from a country with high TB incidence in 81 (31.0%). Sixty-three (24.1%) persons presented at least one AE during treatment, and seven (2.7%) required definitive discontinuation of treatment. In the multivariate analysis, AE development was more frequent in those who started LTBI treatment due to immunosuppression. Overall, 226 (86.6%) completed treatment successfully. We concluded that LTBI screening and treatment groups had different risks for adverse events and treatment outcomes. Persons receiving immunosuppressive treatment were at higher risk of developing AEs, and recently arrived immigrants from countries with a high incidence of TB had greater LTFU. A person-centered adherence and AE management plan is recommended.
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Affiliation(s)
| | | | - María Luisa Aznar
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Grupo de Estudio de Micobacterias (GEIM), Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), 28003 Madrid, Spain
| | - Juan Espinosa Pereiro
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Grupo de Estudio de Micobacterias (GEIM), Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), 28003 Madrid, Spain
| | - Adrián Sánchez-Montalvá
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Grupo de Estudio de Micobacterias (GEIM), Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), 28003 Madrid, Spain
| | - Joan Martínez-Campreciós
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Nuria Saborit
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
| | - José Ángel Rodrigo-Pendás
- Preventive Medicine and Epidemiology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain
| | - Guadalupe García Salgado
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
| | - Claudia Broto Cortes
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
| | - Nuria Serre Delcor
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Inés Oliveira
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Begoña Treviño Maruri
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Diana Pou Ciruelo
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Fernando Salvador
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pau Bosch-Nicolau
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Irene Torrecilla-Martínez
- Preventive Medicine and Epidemiology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain
| | - Ricardo Zules-Oña
- Preventive Medicine and Epidemiology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain
| | - María Teresa Tórtola Fernández
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Microbiology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain
| | - Israel Molina
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Spatial patterns of tuberculosis in Russia in the context of social determinants. Spat Spatiotemporal Epidemiol 2023. [DOI: 10.1016/j.sste.2023.100580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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5
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Decrease in osteoarticular tuberculosis in Spain between 1997 and 2018. REUMATOLOGIA CLINICA 2023; 19:45-48. [PMID: 35764501 DOI: 10.1016/j.reumae.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/09/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVE osteoarticular tuberculosis represents 2%-5% of the manifestations of tuberculosis. The objective was to calculate the incidence and describe the epidemiological characteristics of patients with osteoarticular tuberculosis who received hospital care in Spain between 1997-2018. METHODS A retrospective study was conducted of patients treated with osteoarticular tuberculosis in Spanish hospitals between 1997 and 2018, using the data from the Minimum Basic Data Set at hospital discharge, using the ICD-9-CM and ICD-10 codes. RESULTS 5710 patients with osteoarticular tuberculosis were detected over the 22 years in Spain. The mean annual incidence for the period was 6 cases per million inhabitants (95% CI 5.58-6.30). There was a significant difference between the mean annual incidence per million inhabitants of the first period (1997-2007) of 6.95 and that of the second (2008-2018) of 5.35 (p<.001). CONCLUSIONS The incidence of osteoarticular tuberculosis in Spain is low, has reduced over 22 years and predominates in men.
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Haque M, Mohd Izham M, A Rahman N. Knowledge, attitude and practices related to tuberculosis among students in a public university in East Coast Malaysia. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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7
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Solomos Z, Botsi C, Georgakopoulou T, Lytras T, Tsiodras S, Puchner KP. Active case finding of pulmonary TB in a European refugee camp: lessons learnt from Oinofyta hosting site in Greece. Trop Med Int Health 2021; 26:1068-1074. [PMID: 33991376 DOI: 10.1111/tmi.13626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To report on an active case finding (ACF) intervention that took place in the migrant camp of Oinofyta, Greece, upon suspicion of active TB transmission. METHODS Upon diagnosis of 3 TB cases among camp residents, an ACF intervention among contacts was implemented. All camp residents were offered two-step screening, that is tuberculin skin testing (TST) followed by chest X-ray in case of positive TST (defined as ≥5 mm). RESULTS 336 of 379 (89%) camp residents underwent TST testing, of whom 110 (33%) exhibited a positive skin reaction. The rate of positive TST results was particularly high in the elderly and significantly higher in adults than in children. Differences by sex or nationality were not observed. Of the 110 cases with positive TST, only 75 underwent chest X-ray, resulting in the detection of one pulmonary TB case in an adult woman. CONCLUSIONS In the given intervention context, two-step ACF proved to be operationally cumbersome, with many residents lost to follow-up and a high Number Needed to Screen. Simpler ACF designs should be pilot-tested in similar settings in the future, and blanket screening of all camp residents should be reconsidered. Conclusions drawn by these exercises should pave the way for adopting a comprehensive, context-specific and evidence-based national strategy on TB in migrants.
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Affiliation(s)
| | - Chrisoula Botsi
- Office for Migration Health, National Public Health Organization, Athens, Greece.,Department of Infectious Diseases, Andreas Syggros Hospital, Athens, Greece
| | - Theano Georgakopoulou
- Department for Epidemiological Surveillance and Intervention, National Public Health Organization, Athens, Greece
| | - Theodore Lytras
- Department for Epidemiological Surveillance and Intervention, National Public Health Organization, Athens, Greece
| | - Sotirios Tsiodras
- Medical School, National and Kapodistrian University of Athens, Athens, Greece.,4th Department of Internal Medicine, Attikon University Hospital, Athens, Greece
| | - Karl Philipp Puchner
- Medical School, National and Kapodistrian University of Athens, Athens, Greece.,German Leprosy and TB Relief Association, Würzburg, Germany
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8
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Aznar ML, Espinosa-Pereiro J, Saborit N, Jové N, Sánchez Martinez F, Pérez-Recio S, Vitoria A, Sanjoaquin I, Gallardo E, Llenas-García J, Pomar V, García IO, Cacho J, Goncalves De Freitas L, San Martin JV, García Rodriguez JF, Jiménez-Fuentes MÁ, De Souza-Galvao ML, Tórtola T, Zules R, Molina I, Sánchez-Montalvá A. Impact of the COVID-19 pandemic on tuberculosis management in Spain. Int J Infect Dis 2021; 108:300-305. [PMID: 33930543 PMCID: PMC8078060 DOI: 10.1016/j.ijid.2021.04.075] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 12/22/2022] Open
Abstract
Background The impact of COVID-19 on the diagnosis and management of tuberculosis (TB) patients is unknown. Methods Participating centres completed a structured web-based survey regarding changes to TB patient management during the COVID-19 pandemic. The study also included data from participating centres on patients aged ≥18 diagnosed with TB in 2 periods: March 15 to June 30, 2020 and March 15 to June 30, 2019. Clinical variables and information about patient household contacts were retrospectively collected. Results A total of 7 (70%) TB units reported changes in their usual TB team operations. Across both periods of study, 169 patients were diagnosed with active TB (90 in 2019, 79 in 2020). Patients diagnosed in 2020 showed more frequent bilateral lesions in chest X-ray than patients diagnosed in 2019 (P = 0.004). There was a higher percentage of latent TB infection and active TB among children in households of patients diagnosed in 2020, compared with 2019 (P = 0.001). Conclusions The COVID-19 pandemic has caused substantial changes in TB care. TB patients diagnosed during the COVID-19 pandemic showed more extended pulmonary forms. The increase in latent TB infection and active TB in children of patient households could reflect increased household transmission due to anti-COVID-19 measures.
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Affiliation(s)
- M L Aznar
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain; Mycobacteria Infection Study Group (GEIM, Spanish acronym) from Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC, Spanish acronym), Spain.
| | - J Espinosa-Pereiro
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Saborit
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Jové
- Unitat Clínica de Tuberculosis, Hospital del Mar, Barcelona, Spain
| | | | - S Pérez-Recio
- Tuberculosis Unit, Service of Infectious Diseases, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - A Vitoria
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - I Sanjoaquin
- Infectious Diseases Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - E Gallardo
- Internal Medicine Department, Hospital Vega Baja-FISABIO Orihuela (Alicante, Spain), Clinical Medicine Department, Miguel Hernández University, Elche, Alicante, Spain
| | - J Llenas-García
- Internal Medicine Department, Hospital Vega Baja-FISABIO Orihuela (Alicante, Spain), Clinical Medicine Department, Miguel Hernández University, Elche, Alicante, Spain
| | - V Pomar
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Institut de Recerca del Hospital de la Santa Creu i Sant Pau, Av. Sant Antoni Mª Claret, 167, 08025 Barcelona, Spain
| | - I O García
- Microbiology and Infection's Control Department, Hospital Universitario de Canarias, Tenerife, Spain
| | - J Cacho
- Microbiology Department, Hospital Universitario de Getafe, Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, Spain
| | | | - J V San Martin
- Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - J F García Rodriguez
- Infectious Diseases Unit, Complexo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | | | | | - T Tórtola
- Microbiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Zules
- Preventive Medicine and Epidemiology Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - I Molina
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain; Mycobacteria Infection Study Group (GEIM, Spanish acronym) from Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC, Spanish acronym), Spain
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9
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Otero-Romero S, Sánchez-Montalvá A, Vidal-Jordana A. Assessing and mitigating risk of infection in patients with multiple sclerosis on disease modifying treatment. Expert Rev Clin Immunol 2021; 17:285-300. [PMID: 33543657 DOI: 10.1080/1744666x.2021.1886924] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction: The important development that the multiple sclerosis (MS) treatment field has experienced in the last years comes along with the need of dealing with new adverse events such as the increase risk of infections. In the shared therapeutic decision-making process, the MS expert neurologist should also balance the risks of specific infections under each particular treatment and be familiar with new mitigation strategies.Areas covered: In this review, the authors provide an up-to-date review of the infection risk associated with MS treatments with a specific focus on risk mitigating strategies. The search was conducted using Pubmed® database (2000 - present) to identify publications that reported infection rates and infection complications for each treatment (interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate, fingolimod, cladribine, natalizumab, alemtuzumab, rituximab, and ocrelizumab).Expert opinion: Since the emergence of the first natalizumab-related PML case, the arrival of new MS therapies has come hand in hand with new infectious complications. MS-specialist neurologist has to face new challenges regarding the management of immunosuppression-related infectious complications. The implementation of patient-centered management focus on preventive and mitigating strategies with a multidisciplinary approach should be seen in the future as a marker of excellence of MS management.
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Affiliation(s)
- Susana Otero-Romero
- Department of Preventive Medicine and Epidemiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases. Hospital Universitari Vall d'Hebron, International Health Program Catalan Institute of Health (PROSICS), Universitat Autònoma De Barcelona, Barcelona, Spain.,Micobacteria Infections Study Group (GEIM) of the Spanish Society of Infectious Diseases (SEIMC), Spain
| | - Angela Vidal-Jordana
- Department of Neurology-Neuroimmunology and Multiple Sclerosis Centre of Catalonia (Cemcat). Hospital Universitari Vall d'Hebron, Universitat Autònoma De Barcelona, Barcelona, Spain
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10
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Bonvicini F, Cilloni S, Fornaciari R, Casoni C, Marchesi C, Greci M, Monici L, Nicolini F, Vinceti M. Compliance with Tuberculosis Screening in Irregular Immigrants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010028. [PMID: 30583597 PMCID: PMC6339090 DOI: 10.3390/ijerph16010028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 12/27/2022]
Abstract
Tuberculosis (TB) is a serious public health problem in many regions of the world, especially in the poorest areas. For this reason, screening for active and latent forms must be considered when dealing with high-risk groups such as irregular immigrants in Western countries. We conducted a retrospective cohort study by recruiting subjects aged ≥15 years who underwent a tuberculin skin test at a dedicated National Health Service Centre in a northern Italian province between 1 January 2012 and 31 December 2013. These participants were followed up until 31 December 2016. We aimed at evaluating an experimental protocol for active and latent tuberculosis screening, focusing on patient compliance, feasibility, and capability to detect clinical forms of the disease. We enrolled 368 irregular immigrants, i.e., immigrants not having a valid residence permit and who were therefore not entitled to choose a general practitioner. In total, 90.22% of these completed all the steps for the screening of active TB, while 87.33% also undertook screening for the latent form of the disease. Homelessness, self-reported prostitution, female sex, and employment status adversely affected compliance. Chronic alcohol consumption was associated with increased risk of no beginning or interruption of the procedures. All of the five patients with active TB successfully completed the treatment. Overall, adherence to the screening program was high compared to other studies in immigrants, possibly owing to organizational factors such as the availability of cultural mediators, the network between the different health services, the presence of dedicated nursing staff and a free-of-charge service. In addition, selected vulnerable subgroups should be targeted using tailored screening and follow-up programs.
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Affiliation(s)
- Francesca Bonvicini
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Silvia Cilloni
- Università degli Studi di Modena e Reggio Emilia, Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Modena 41125, Italy.
| | - Rossano Fornaciari
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Carmen Casoni
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Cristina Marchesi
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Marina Greci
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Lucia Monici
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Fausto Nicolini
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Marco Vinceti
- Università degli Studi di Modena e Reggio Emilia, Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Modena 41125, Italy.
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