scholarly journals Knowledge, attitudes, beliefs, and stigma related to latent tuberculosis infection: a qualitative study among Eritreans in the Netherlands

2020 ◽  
Author(s):  
Ineke Spruijt ◽  
Dawit Tesfay Haile ◽  
Susan van den Hof ◽  
Kathy Fiekert ◽  
Niesje Jansen ◽  
...  
Keyword(s):  
Asylum Seekers ◽  
Cultural Beliefs ◽  
Latent Tuberculosis ◽  
Treatment Programs ◽  
Treatment Cascade ◽  
Individual Interviews ◽  
Ltbi Screening ◽  
Latent Tb Infection ◽  
Anticipated Stigma ◽  
Asylum Seekers And Refugees

Abstract Background Tailored and culturally appropriate latent tuberculosis (TB) infection screening and treatment programs, including interventions against TB stigma, are needed to reduce TB incidence in low TB incidence countries. However, we lack insights in stigma related to latent TB infection (LTBI) among target groups, such as asylum seekers and refugees. We therefore studied knowledge, attitudes, beliefs and stigma associated with LTBI among Eritrean asylum seekers and refugees in the Netherlands.Methods We interviewed adult Eritrean asylum seekers and refugees: 26 semi-structured group interviews following TB and LTBI related health education and LTBI screening, and 31 semi-structured individual interviews with Eritreans during or after completion of LTBI treatment. We used a thematic analysis to identify, analyse and report patterns in the data.Results Despite TB/LTBI education, misconceptions embedded in cultural beliefs about TB transmission and prevention persisted. Fear of getting infected with TB was the cause of reported enacted (isolation and gossip) and anticipated (concealment of treatment and self-isolation) stigma by participants on LTBI treatment.Conclusion The inability to differentiate LTBI from TB disease and consequent fear of getting infected by persons with LTBI led to enacted and anticipated stigma comparable to stigma related to TB disease among Eritreans. Additional to continuous culturally sensitive education activities, TB prevention programs should implement evidence-based interventions reducing stigma at all phases in the LTBI screening and treatment cascade.

scholarly journals Knowledge, attitudes, beliefs, and stigma related to latent tuberculosis infection: a qualitative study among Eritreans in the Netherlands

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ineke Spruijt ◽  
Dawit Tesfay Haile ◽  
Susan van den Hof ◽  
Kathy Fiekert ◽  
Niesje Jansen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Asylum Seekers ◽  
Cultural Beliefs ◽  
Latent Tuberculosis ◽  
Treatment Programs ◽  
Ltbi Treatment ◽  
Treatment Cascade ◽  
Ltbi Screening ◽  
Latent Tb Infection ◽  
Asylum Seekers And Refugees

Abstract Background Tailored and culturally appropriate latent tuberculosis (TB) infection screening and treatment programs, including interventions against TB stigma, are needed to reduce TB incidence in low TB incidence countries. However, we lack insights in stigma related to latent TB infection (LTBI) among target groups, such as asylum seekers and refugees. We therefore studied knowledge, attitudes, beliefs, and stigma associated with LTBI among Eritrean asylum seekers and refugees in the Netherlands. Methods We used convenience sampling to interview adult Eritrean asylum seekers and refugees: 26 semi-structured group interviews following TB and LTBI related health education and LTBI screening, and 31 semi-structured individual interviews with Eritreans during or after completion of LTBI treatment (November 2016–May 2018). We used a thematic analysis to identify, analyse and report patterns in the data. Results Despite TB/LTBI education, misconceptions embedded in cultural beliefs about TB transmission and prevention persisted. Fear of getting infected with TB was the cause of reported enacted (isolation and gossip) and anticipated (concealment of treatment and self-isolation) stigma by participants on LTBI treatment. Conclusion The inability to differentiate LTBI from TB disease and consequent fear of getting infected by persons with LTBI led to enacted and anticipated stigma comparable to stigma related to TB disease among Eritreans. Additional to continuous culturally sensitive education activities, TB prevention programs should implement evidence-based interventions reducing stigma at all phases in the LTBI screening and treatment cascade.

scholarly journals Knowledge, attitudes, beliefs, and stigma related to latent tuberculosis infection: a qualitative study among Eritreans in the Netherlands

2020 ◽  
Author(s):  
Ineke Spruijt ◽  
Dawit Tesfay Haile ◽  
Susan van den Hof ◽  
Kathy Fiekert ◽  
Niesje Jansen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Asylum Seekers ◽  
Cultural Beliefs ◽  
Latent Tuberculosis ◽  
Treatment Programs ◽  
Ltbi Treatment ◽  
Treatment Cascade ◽  
Ltbi Screening ◽  
Latent Tb Infection ◽  
Asylum Seekers And Refugees

Abstract Background: Tailored and culturally appropriate latent tuberculosis (TB) infection screening and treatment programs, including interventions against TB stigma, are needed to reduce TB incidence in low TB incidence countries. However, we lack insights in stigma related to latent TB infection (LTBI) among target groups, such as asylum seekers and refugees. We therefore studied knowledge, attitudes, beliefs and stigma associated with LTBI among Eritrean asylum seekers and refugees in the Netherlands.Methods: We used convenience sampling to interview adult Eritrean asylum seekers and refugees: 26 semi-structured group interviews following TB and LTBI related health education and LTBI screening, and 31 semi-structured individual interviews with Eritreans during or after completion of LTBI treatment (November 2016-May 2018). We used a thematic analysis to identify, analyse and report patterns in the data.Results: Despite TB/LTBI education, misconceptions embedded in cultural beliefs about TB transmission and prevention persisted. Fear of getting infected with TB was the cause of reported enacted (isolation and gossip) and anticipated (concealment of treatment and self-isolation) stigma by participants on LTBI treatment. Conclusion: The inability to differentiate LTBI from TB disease and consequent fear of getting infected by persons with LTBI led to enacted and anticipated stigma comparable to stigma related to TB disease among Eritreans. Additional to continuous culturally sensitive education activities, TB prevention programs should implement evidence-based interventions reducing stigma at all phases in the LTBI screening and treatment cascade.

scholarly journals Knowledge, attitudes, beliefs, and stigma related to latent tuberculosis infection: a qualitative study among Eritreans in the Netherlands

2020 ◽  
Author(s):  
Ineke Spruijt ◽  
Dawit Tesfay Haile ◽  
Susan van den Hof ◽  
Kathy Fiekert ◽  
Niesje Jansen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Asylum Seekers ◽  
Cultural Beliefs ◽  
Latent Tuberculosis ◽  
Treatment Programs ◽  
Ltbi Treatment ◽  
Treatment Cascade ◽  
Ltbi Screening ◽  
Latent Tb Infection ◽  
Asylum Seekers And Refugees

Abstract Background: Tailored and culturally appropriate latent tuberculosis (TB) infection screening and treatment programs, including interventions against TB stigma, are needed to reduce TB incidence in low TB incidence countries. However, we lack insights in stigma related to latent TB infection (LTBI) among target groups, such as asylum seekers and refugees. We therefore studied knowledge, attitudes, beliefs and stigma associated with LTBI among Eritrean asylum seekers and refugees in the Netherlands.Methods: We used convenience sampling to interview adult Eritrean asylum seekers and refugees: 26 semi-structured group interviews following TB and LTBI related health education and LTBI screening, and 31 semi-structured individual interviews with Eritreans during or after completion of LTBI treatment (November 2016-May 2018). We used a thematic analysis to identify, analyse and report patterns in the data.Results: Despite TB/LTBI education, misconceptions embedded in cultural beliefs about TB transmission and prevention persisted. Fear of getting infected with TB was the cause of reported enacted (isolation and gossip) and anticipated (concealment of treatment and self-isolation) stigma by participants on LTBI treatment. Conclusion: The inability to differentiate LTBI from TB disease and consequent fear of getting infected by persons with LTBI led to enacted and anticipated stigma comparable to stigma related to TB disease among Eritreans. Additional to continuous culturally sensitive education activities, TB prevention programs should implement evidence-based interventions reducing stigma at all phases in the LTBI screening and treatment cascade.

scholarly journals Knowledge, attitudes, beliefs, and stigma related to latent tuberculosis infection: a qualitative study among Eritreans in the Netherlands

2020 ◽  
Author(s):  
Ineke Spruijt ◽  
Dawit Tesfay Haile ◽  
Susan van den Hof ◽  
Kathy Fiekert ◽  
Niesje Jansen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Asylum Seekers ◽  
Cultural Beliefs ◽  
Latent Tuberculosis ◽  
Treatment Programs ◽  
Ltbi Treatment ◽  
Treatment Cascade ◽  
Ltbi Screening ◽  
Latent Tb Infection ◽  
Asylum Seekers And Refugees

Abstract Background: Tailored and culturally appropriate latent tuberculosis (TB) infection screening and treatment programs, including interventions against TB stigma, are needed to reduce TB incidence in low TB incidence countries. However, we lack insights in stigma related to latent TB infection (LTBI) among target groups, such as asylum seekers and refugees. We therefore studied knowledge, attitudes, beliefs, and stigma associated with LTBI among Eritrean asylum seekers and refugees in the Netherlands.Methods: We used convenience sampling to interview adult Eritrean asylum seekers and refugees: 26 semi-structured group interviews following TB and LTBI related health education and LTBI screening, and 31 semi-structured individual interviews with Eritreans during or after completion of LTBI treatment (November 2016-May 2018). We used a thematic analysis to identify, analyse and report patterns in the data.Results: Despite TB/LTBI education, misconceptions embedded in cultural beliefs about TB transmission and prevention persisted. Fear of getting infected with TB was the cause of reported enacted (isolation and gossip) and anticipated (concealment of treatment and self-isolation) stigma by participants on LTBI treatment.Conclusion: The inability to differentiate LTBI from TB disease and consequent fear of getting infected by persons with LTBI led to enacted and anticipated stigma comparable to stigma related to TB disease among Eritreans. Additional to continuous culturally sensitive education activities, TB prevention programs should implement evidence-based interventions reducing stigma at all phases in the LTBI screening and treatment cascade.

scholarly journals Latent tuberculosis screening and treatment among asylum seekers: a mixed-methods study

2019 ◽  
Vol 54 (5) ◽  
pp. 1900861 ◽  
Author(s):  
Ineke Spruijt ◽  
Dawit Tesfay Haile ◽  
Jeanine Suurmond ◽  
Susan van den Hof ◽  
Marga Koenders ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Asylum Seeker ◽  
Asylum Seekers ◽  
Latent Tuberculosis ◽  
Care Staff ◽  
Public Health Services ◽  
Tuberculosis Screening ◽  
Ltbi Treatment ◽  
Treatment Cascade ◽  
Ltbi Screening

IntroductionEvidence on conditions for implementation of latent tuberculosis infection (LTBI) screening and treatment among asylum seekers is needed to inform tuberculosis (TB) control policies. We used mixed-methods to evaluate the implementation of an LTBI screening and treatment programme among asylum seekers in the Netherlands.MethodsWe offered voluntary LTBI screening to asylum seekers aged ≥12 years living in asylum seeker centres from countries with a TB incidence >200 per 10 000 population. We calculated LTBI screening and treatment cascade coverage, and assessed associated factors with Poisson regression using robust variance estimators. We interviewed TB care staff (seven group interviews) and Eritrean clients (21 group and 21 individual interviews) to identify programme enhancers and barriers.ResultsWe screened 719 (63% of 1136) clients for LTBI. LTBI was diagnosed among 178 (25%) clients; 149 (84%) initiated LTBI treatment, of whom 129 (87%) completed treatment. In-person TB and LTBI education, the use of professional interpreters, and collaboration with partner organisations were enhancers for LTBI screening uptake. Demand-driven LTBI treatment support by TB nurses enhanced treatment completion. Factors complicating LTBI screening and treatment were having to travel to public health services, language barriers and moving from asylum seeker centres to the community during treatment.ConclusionLTBI screening and treatment of asylum seekers is feasible and effective when high quality of care is provided, including culture-sensitive TB education throughout the care cascade. Additionally, collaboration with partner organisations, such as agencies responsible for reception and support of asylum seekers, should be in place.

Evaluation of the latent tuberculosis screening and treatment strategy for asylum seekers in Stockholm, Sweden 2015–2018 - a record linkage study of the care cascade

2020 ◽  
pp. 2002255
Author(s):  
Joanna Nederby Öhd ◽  
Maria-Pia Hergens ◽  
Yauheni Luksha ◽  
Charlotte Buxbaum ◽  
Jad Shedrawy ◽  
...  
Keyword(s):  
Host Country ◽  
Record Linkage ◽  
Asylum Seekers ◽  
Latent Tuberculosis ◽  
Linkage Study ◽  
Tuberculosis Screening ◽  
Care Cascade ◽  
High Incidence ◽  
Latent Tb ◽  
Latent Tb Infection

In many countries with low tuberculosis (TB) incidence (<10/100,000) a high proportion of cases originate from latent TB infection (LTBI) reactivation among migrants from high-incidence countries (≥100/100,000) who have been infected before arrival in the host country [1, 2]. Consequently, LTBI screening and management for migrants is an important intervention to reduce TB incidence in those countries [1, 3, 4].

scholarly journals Strategies to reach and motivate migrant communities at high risk for TB to participate in latent tuberculosis infection screening program: a community-engaged mixed methods study among Eritreans

2019 ◽  
Author(s):  
Ineke Spruijt ◽  
Dawit Tesfay Haile ◽  
Connie Erkens ◽  
Susan van den Hof ◽  
Simone Goosen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Screening Program ◽  
Latent Tuberculosis ◽  
Good Health ◽  
Target Group ◽  
Care Staff ◽  
Treatment Programs ◽  
Migrant Communities ◽  
Migrant Populations ◽  
Ltbi Screening

Abstract Background: In the Netherlands, migrant populations with a high TB incidence are an important target group for TB prevention programs. However, there is a lack of insight in community-engaged strategies to reach and motivate those migrants to participate in a latent TB infection (LTBI) education, screening and treatment program.Methods: In co-creation with Eritrean key figures and TB care staff, we designed and executed six strategies to reach and motivate Eritrean communities to participate in LTBI screening and treatment programs in five regions in the Netherlands. We registered participation in LTBI education and screening, and uptake and completion of LTBI treatment. We used semi-structured group and individual interviews with Eritrean participants and key figures, and TB care staff to identify program facilitators and barriers.Results: Uptake of LTBI education and consequent screening varied between strategies (13% - 75% and 10% - 124% respectively). The program resulted in high treatment initiation and completion (both 97%) among those diagnosed with LTBI. Strategies using face-to-face promotion and targeting smaller groups were most successful. Reported program barriers included: competing priorities in the target group, perceived good health, poor risk perception, and skepticism towards the program purpose. TB staff perceived the program as useful but demanding in terms of human resources.Conclusions: Migrant communities can be successfully reached and motivated for LTBI screening and treatment programs, when sufficient (human) resources are in place and community-members, well connected to and trusted by the community, are engaged in the design and execution of the program.

scholarly journals Evaluating 17 years of latent tuberculosis infection screening in north-west England: a retrospective cohort study of reactivation

2017 ◽  
Vol 50 (1) ◽  
pp. 1602505 ◽  
Author(s):  
Dominik Zenner ◽  
Miranda G. Loutet ◽  
Ross Harris ◽  
Stephen Wilson ◽  
L. Peter Ormerod
Keyword(s):  
Retrospective Cohort ◽  
Strong Association ◽  
Latent Tuberculosis ◽  
Incidence Rates ◽  
North West ◽  
Ltbi Screening ◽  
Treatment Naïve ◽  
Positive Treatment ◽  
Latent Tb Infection ◽  
Rate Ratios

Approximately 72% of tuberculosis (TB) cases in England occur among non-UK born individuals, mostly as a result of reactivation of latent TB infection (LTBI). Programmatic LTBI screening is a key intervention of the TB strategy for England. This article reviews the results of a long-standing LTBI screening initiative in England.A retrospective cohort was created through probabilistic linkage between LTBI screening data and national TB case notifications. Screened persons were followed until they died, became a case, emigrated or until cohort-end. TB incidence rates and rate ratios (IRR) were calculated.97 out of 1820 individuals screened for LTBI were reported to have active TB. Crude incidence rates among LTBI-positive, treatment-naïve individuals were 4.1 and 2.3 per 100 person-years in the QuantiFERON and tuberculin skin test cohorts, respectively. Among the QuantiFERON cohort, Poisson regression showed that LTBI positivity (IRR 22.6, 95% CI 6.8–74.6) and no chemoprophylaxis increased the probability of becoming a TB case (IRR 0.17, 95% CI 0.05–0.6).We found high TB rates in LTBI-positive, treatment-naïve individuals and a strong association between no treatment and becoming a TB case, demonstrating feasibility and effectiveness of LTBI screening and providing important policy lessons for LTBI screening in England and beyond.

Surveillance of Employees of Swiss Federal Asylum Centres for Latent Tuberculosis Infection

Respiration ◽  
2021 ◽  
pp. 369-373
Author(s):  
Jean-Pierre Zellweger ◽  
Ariane Zellweger-Landry ◽  
Jean-Marie Egger ◽  
Annette Koller-Doser ◽  
Axel Jeremias Schmidt
Keyword(s):  
Asylum Seekers ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Active Tuberculosis ◽  
Interferon Gamma Release Assay ◽  
Work Related ◽  
Release Assay ◽  
Latent Tb ◽  
Latent Tb Infection

Background: Asylum seekers in Switzerland have to register in federal asylum centres (FACs) before formal permission to enter the country. Some of them may have active tuberculosis (TB), exposing fellow refugees and employees. Objectives: The aim of this study was to assess the risk of TB infection among employees of Swiss FACs. Methods: Between 2010 and 2018, a free interferon-gamma release assay (IGRA) was offered to all employees of 8 FACs, at employment and at yearly intervals. We defined latent TB infection as IGRA conversion from negative to positive. IGRA-positive employees were referred to a medical centre for further clinical follow-up. Results: 1,427 tests were performed among 737 employees (54.6% male). 403 (55%) persons were tested only once; 330 (44.5%) were tested several times; for 4 (0.5%) persons, the number of IGRA tests is unknown. Twenty employees (2.7%) had a positive IGRA at baseline, 2 (0.6%) converted from negative to positive during follow-up, resulting in an incidence of 22/10,000 person-years. We observed no case of active TB among employees. Conclusions: The prevalence of latent TB among employees to Swiss FACs and the risk of acquiring TB infection through work-related exposure are low. Yearly IGRA controls in the absence of documented TB exposure seem unnecessary.

scholarly journals Strategies to reach and motivate migrant communities at high risk for TB to participate in a latent tuberculosis infection screening program: a community-engaged mixed methods study among Eritreans

2020 ◽  
Author(s):  
Ineke Spruijt ◽  
Dawit Tesfay Haile ◽  
Connie Erkens ◽  
Susan van den Hof ◽  
Simone Goosen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Human Resources ◽  
Screening Program ◽  
Latent Tuberculosis ◽  
Good Health ◽  
Target Group ◽  
Treatment Programs ◽  
Ltbi Treatment ◽  
Migrant Communities ◽  
Ltbi Screening

Abstract Background: In the Netherlands, migrant populations with a high tuberculosis (TB) incidence are an important target group for TB prevention. However, there is a lack of insight in effective community-engaged strategies to reach and motivate these migrants to participate in latent TB infection (LTBI) screening and treatment programs. Methods: In cocreation with Eritrean key figures and TB staff, we designed and executed six strategies to reach and motivate Eritrean communities to participate in LTBI programs, in five regions in the Netherlands. We registered participation in LTBI education and screening, and LTBI treatment uptake and completion. We used semi-structured group and individual interviews with Eritrean participants, key figures, and TB staff to identify facilitators and barriers. Results: Uptake of LTBI education (13% - 75%) and consequent screening (10% - 124%) varied between strategies. LTBI screening uptake >100% resulted from educated participants motivating others to participate in screening. Two strategies, using face-to-face promotion and targeting smaller groups, were the most successful. The program resulted in high LTBI treatment initiation and completion (both 97%). Reported program barriers included: competing priorities in the target group, perceived good health, poor risk perception, and scepticism towards the program purpose. TB staff perceived the program as useful but demanding in terms of human resources. Conclusions: Eritrean migrant communities can be successfully reached and motivated for LTBI screening and treatment programs, when sufficient (human) resources are in place and community members, well-connected to and trusted by the community, are engaged in the design and execution of the program.

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