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[The results of an active screening program for tuberculosis in immigrants from the Maghreb: acceptability and
F P Rivas-Clemente1, M Nácher-Conches, J Corrillero-Martín
1Centro de Salud de Collado Villalba, Madrid.
Objective:
To assess acceptability and adherence to a tuberculosis screening programme (TSP) in Maghrebi immigrants (MI).
Design:
A descriptive crossover study.
Setting:
Primary health care service.
Individuals:
MI residing in a periurban health district. All people who attended clinic for consultation at a primary care center were systematically recommended to be screened for tuberculosis.
Intervention:
Individuals accomplished a questionnaire in arabic (with interpreter assistance) and were subjected to tuberculosis infection/illness screening tests till they were assigned one of the definitive diagnostic classes of the American Thoracic Society.
Results:
219 individuals were offered the TSP (sex ratio 6.2:1). 166 individuals (76.1%) accepted the test and kept their first appointment: 147 males (78.2%) versus 19 females (63.3%); difference in acceptance by gender was not significant (chi 2 = 3.14; p = 0.07). Fourteen individuals did not complete the study (8.6%): one did not attend clinic for Mantoux reading, four did not have the chest X-ray, three did not present themselves on their Mantoux reading, nor did they have the chest X-ray and, six did not deliver sputum samples (11.1% of the required samples). Six cases of TB were diagnosed.
Conclusions:
Given the special features of the MI (communication difficulties, illegal status, no fixed abode ...) acceptance and adherence to TSP are considered to be high. The diagnostic effectiveness, though considerable, was affected by the high number of individuals which did not deliver sputum samples. TSP directed to MI must have a specific design in order to facilitate acceptance and adherence.