Changes in tuberculin sensitivity among first-grade students of elementary schools in Evros, Greece due to immigration

• Published in: Public health (London) Vol. 123; no. 9; pp. 618 - 622
• Main Authors: Mantadakis, E, Arvanitidou, V, Tsalkidis, A, Ramatani, A, Triantafillidou, E, Trypsianis, G, Dipla, V, Thomaidis, S, Bouros, D, Chatzimichael, A
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.09.2009
• Subjects: Child; Emigration and Immigration - statistics & numerical data; Epidemiology; Female; Greece; Greece - epidemiology; Humans; Immigration; Infectious Disease; Internal Medicine; Male; Mantoux skin test; Mass Screening - methods; Mass Screening - statistics & numerical data; Mycobacterium; Population Surveillance; Prevalence; Retrospective Studies; Schools; Sensitivity and Specificity; Students; Tuberculin Test - methods; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - epidemiology; Tuberculosis - prevention & control; Vaccination - statistics & numerical data; Greece; Greece; Immigration; Tuberculosis; Mantoux skin test; Epidemiology
• ISSN: 0033-3506; 1476-5616
• DOI: 10.1016/j.puhe.2009.07.003

Summary Objective To investigate the tuberculin sensitivity trends among first-grade students of elementary schools tested according to the Greek national school-based screening and vaccination programme. Study design Retrospective analysis of tuberculin skin test (TST) results from 1988 to 2004 in unvaccinated first-grade students in Evros, Greece. Methods All 6–7-year-old children who were unvaccinated for tuberculosis were tested by a highly experienced team. This study tested whether gender (male vs female), national origin (native vs foreign-born children) and place of residence (urban vs semi-urban vs rural) correlated with tuberculin reaction positivity. Results In total, 8588 children (47.1% girls) were tested. Tuberculin reaction positivity was independent of gender. The difference in TST positivity between native and foreign-born children between 1993 and 2004 was highly significant, with substantially more foreign-born children having a positive Mantoux test ( P < 0.0001). The percentage of children with a positive TST peaked at 13% in 1995 due to initial admission of foreign-born children, originating from countries of the former Soviet Union, into the Greek educational system. In addition, a positive Mantoux test was more common among children living in rural (8.1%) and semi-urban (6.4%) areas compared with children living in urban areas (3.5%, P < 0.0001). Conclusion The increase in TST positivity noted was due to admission of foreign-born children into the Greek educational system. School-based tuberculosis screening programmes should continue in Greece because the prevalence of tuberculosis appears to show substantial variation between years.