Prevalence of tuberculosis in migrant children in Switzerland and relevance of current screening guidelines

Abstract

AIMS: Since 2016, Swiss guidelines recommend screening of all migrant children = 5 years of age when the tuberculin skin test was positive. Children with clinical and/or radiological signs of tuberculosis disease were further investigated. Children >= 5 years of age with a positive tuberculosis-spot test and children = 5 years of age when the tuberculosis-spot test was negative. Potential determinants of tuberculosis (latent tuberculosis and tuberculosis disease) and of false-positive tuberculin skin tests were identified. Student's t-test or the Kruskal-Wallis test were used for continuous variables and the chi-square test or Fisher's exact test for categorical variables. All variables with a p-value = 80 cases per 100,000 individuals). Twenty-eight patients (11%) had positive tuberculin skin tests, and tuberculosis was confirmed in 17 (6.7%) of these patients (16 with latent tuberculosis and 1 with tuberculosis disease). On multivariate analysis, moderate-high incidence of tuberculosis disease in the country of origin (adjusted odds ratio [aOR] 18.8, 95% confidence interval [CI] 5.1-68.6; p = 5 years of age for tuberculosis could confer a public health benefit even in the absence of other risk factors. The limit of tuberculin skin test positivity could be raised from >= 5 mm to >= 10 mm to decrease the rate of false-positive results. A national assessment of migrant children between the ages of 5 and 15 should be carried out to confirm our findings.