Pre-immigration screening process and pulmonary tuberculosis among Ethiopian migrants in Israel

Abstract

More than 75,000 displaced Ethiopians have moved to Israel. Tuberculosis (TB) incidence in Ethiopia is 44 times higher than in Israel (344 versus 8 cases per 100,000 inhabitants, respectively). The aims of the present retrospective cohort study were to evaluate the preimmigration screening process initiated in 2001 on pulmonary TB (PTB) morbidity and to assess its cost-effectiveness.Ethiopian immigrants who were screened before departure (study group) were compared with those who were screened after arrival (comparison group).Between 1998 and 2005, 24,051 Ethiopian immigrants arrived in Israel. PTB was diagnosed in 332 (1.4%) immigrants, an incidence density of 325 patients per 100,000 person-yrs. PTB cumulative incidence was lower in the study group than in the comparison group: 711 compared with 1,746 patients per 100,000 immigrants, respectively (rate ratio 0.4). PTB was detected significantly earlier in the study group than in the comparison group: 193 versus 487 days after entry, respectively. Disease incidence declined significantly during the first 2 yrs following immigration. A 5-yr predictive model indicated that 98 individuals would be free of PTB, saving US$91,055 on annual treatment cost, due to screening.The pre-immigration screening process reduced pulmonary tuberculosis incidence in subsequent years following immigration. Pulmonary tuberculosis was diagnosed earlier in the screened group than in the comparison group and the process was found to be both costbeneficial and cost-effective.

Pre-immigration screening for pulmonary tuberculosis

“…The authors thank BHUNIYA [1] for his interesting comments on our article published in the European Respiratory Journal (ERJ) [2]. Tuberculosis (TB) screening policies are influenced by the structure of the national TB programme, the existing financial resources, the expertise of available professionals and the sense of apprehension expressed by the local population in the host country.…”

“…In 1998, VIZZA et al [2] examined a large group of patients with advanced lung diseases and estimated that 6% of them had LV failure, in particular patients with primary pulmonary hypertension and Eisenmenger's syndrome. However, in a patient group with interstitial lung diseases (ILD) the proportion was lower and reached 3.6%.…”

Tuberculosis Infection in Cattle and Cattle Owners in North Eastern Parts of Ethiopia

“…WHO [2] reported that 98% of tuberculosis deaths occurred in the developing world, affecting mostly young adults in their productive ages. Despite efforts made, globally or nationally to curb the effects of TB, different studies have shown that the trend of pulmonary TB remained as a health problem in the world [3][4][5][6][7]. In 2013, WHO [8] reported a decline in the impact of tuberculosis by the year 2012.…”

Pre-immigration screening for pulmonary tuberculosis: the unanswered questions

“…In a recent issue of the European Respiratory Journal, the article by MOR et al [1] captured my interest. The results are no doubt promising but there are some points of concern that need to be highlighted.…”

“…Secondly, the reliability of chest radiography, used as a tool for screening in the study of MOR et al [1] is still questionable. Persons with normal chest radiography may have active PTB [7], and even persons with chest radiography showing shadows suggestive of PTB may in reality not have active tuberculosis.…”