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Int. J. Environ. Res. Public Health 2018, 15(6), 1263; https://doi.org/10.3390/ijerph15061263

Tuberculosis Specific Interferon-Gamma Production in a Current Refugee Cohort in Western Europe

1
Department of Clinical Immunology and Rheumatology, Hannover Medical School, 30625 Hannover, Germany
2
German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, 30625 Hannover, Germany
3
Department of Pediatrics, Neonatology and Allergology, Hannover Medical School, 30625 Hannover, Germany
4
German Center for Lung Research, Partner Site Hannover BREATH, 30625 Hannover, Germany
5
Hannover Medical School, 30625 Hannover, Germany
6
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, 30625 Hannover, Germany
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 21 April 2018 / Revised: 6 June 2018 / Accepted: 11 June 2018 / Published: 14 June 2018
(This article belongs to the Special Issue Refugee, Migrant and Ethnic Minority Health)
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Abstract

Background: In 2015, a high number of refugees with largely unknown health statuses immigrated to Western Europe. To improve caretaking strategies, we assessed the prevalence of latent tuberculosis infection (LTBI) in a refugee cohort. Methods: Interferon-Gamma release assays (IGRA, Quantiferon) were performed in n = 232 inhabitants of four German refugee centers in the summer of 2015. Results: Most refugees were young, male adults. Overall, IGRA testing was positive in 17.9% (95% CI = 13.2–23.5%) of subjects. Positivity rates increased with age (0% <18 years versus 46.2% >50 years). Age was the only factor significantly associated with a positive IGRA in multiple regression analysis including gender, C reactive protein, hemoglobin, leukocyte, and thrombocyte count and lymphocyte, monocyte, neutrophil, basophil, and eosinophil fraction. For one year change in age, the odds are expected to be 1.06 times larger, holding all other variables constant (p = 0.015). Conclusion: Observed LTBI frequencies are lower than previously reported in similar refugee cohorts. However, as elderly people are at higher risk for developing active tuberculosis, the observed high rate of LTBI in senior refugees emphasizes the need for new policies on the detection and treatment regimens in this group. View Full-Text
Keywords: tuberculosis; LTBI; refugee; asylum; infection; IGRA; infectious diseases; migrant tuberculosis; LTBI; refugee; asylum; infection; IGRA; infectious diseases; migrant
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Jablonka, A.; Dopfer, C.; Happle, C.; Sogkas, G.; Ernst, D.; Atschekzei, F.; Hirsch, S.; Schäll, A.; Jirmo, A.; Solbach, P.; Schmidt, R.E.; Behrens, G.M.N.; Wetzke, M. Tuberculosis Specific Interferon-Gamma Production in a Current Refugee Cohort in Western Europe. Int. J. Environ. Res. Public Health 2018, 15, 1263.

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