Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 1;14(7):e0218039.
doi: 10.1371/journal.pone.0218039. eCollection 2019.

App-based symptoms screening with Xpert MTB/RIF Ultra assay used for active tuberculosis detection in migrants at point of arrivals in Italy: The E-DETECT TB intervention analysis

Lucia Barcellini  1 , Emanuele Borroni  1 , Claudia Cimaglia  2 , Enrico Girardi  2 , Alberto Matteelli  3 , Valentina Marchese  3 , Giovanna Stancanelli  1 , Ibrahim Abubakar  4 ; members of the E-Detect TB Consortium; Daniela Maria Cirillo  1
Affiliations

App-based symptoms screening with Xpert MTB/RIF Ultra assay used for active tuberculosis detection in migrants at point of arrivals in Italy: The E-DETECT TB intervention analysis

Lucia Barcellini et al. PLoS One. .

Abstract

Background: From 2014 to 2017, the number of migrants who came to Italy via the Mediterranean route has reached an unprecedented level. The majority of refugees and migrants were rescued in the Central Mediterranean and disembarked at ports in the Sicily region. Rapid on-spot active TB screening intervention at the point of arrival will cover most migrants arriving in EU and by detecting TB prevalent cases will limit further transmission of the disease.

Material and methods: Between November 2016 and December 2017 newly arrived migrants at point of arrivals in Sicily, were screened for active Tuberculosis using a smartphone application, followed in symptomatic individuals by fast molecular test, Xpert MTB/RIF Ultra, on collected sputum samples.

Results: In the study period 3787 migrants received a medical evaluation. Eight hundred and ninety-one (23.5%) reported at least one protocol-defined Tuberculosis symptom. Fifteen (2.7%) were positive to at least one microbiological test revealing a post-entry screening prevalence rate of 396 per 100.000 individuals screened (95% CI: 2.22-6.53). In logistic regression analysis, those with cough and at least one other symptom had an increased probability of testing positive compared to persons with symptoms other than cough. Whole-genome-sequencing demonstrate two separate cases of transmission.

Discussion: To our knowledge this study reports first-time results of an active TB case finding strategy based on on-spot symptom screening using a smartphone application, followed by fast molecular test on collected sputum samples. Our preliminary findings reveal a post-entry screening prevalence rate of 396 per 100.000 individuals screened (95% CI: 2.22-6.53).

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flow diagram.
See this image and copyright information in PMC

References

    1. EUROPE KEYDATA-2017 Arrivals in Europe [Internet]. [cited 2018 Nov 10]. Available from: https://data2.unhcr.org/en/documents/download/62326
    1. UNHCR Central Mediterranean Risk Mitigation Strategy, (CMRMS). Central Mediterranean Route: Working on alternatives to dangerous journeys [Internet]. 2017 [cited 2018 Nov 10]. Available from: http://www.refworld.org/docid/47fdfb491a.html.
    1. UNHCR. EU EMERGENCY RELOCATION MECHANISM [Internet]. [cited 2018 Nov 10]. Available from: https://data2.unhcr.org/en/documents/download/58668
    1. Kunst H, Burman M, Arnesen TM, Fiebig L, Hergens M-P, Kalkouni O, et al. Tuberculosis and latent tuberculous infection screening of migrants in Europe: comparative analysis of policies, surveillance systems and results. Int J Tuberc Lung Dis [Internet]. 2017. August 1 [cited 2017 Aug 26];21(8):840–51. Available from: http://www.ingentaconnect.com/content/10.5588/ijtld.17.0036 10.5588/ijtld.17.0036 - DOI - DOI - PubMed
    1. European Centre for Disease Prevention and Control. Tuberculosis surveillance and monitoring in Europe Tuberculosis surveillance and monitoring in Europe 2017. ECDC [Internet]. Jean-Paul Guthman Lena Fiebig Gabor Kovács Thorsteinn Blondal; 2017 [cited 2017 Aug 26]; Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publicat...

Publication types

MeSH terms