Giuseppe
Emeritus
[Source: Eurosurveillance, full text: (LINK). Abstract, edited.]
Z Mor (
)<SUP>1</SUP>, H Kolb<SUP>2</SUP>, M Lidji<SUP>3</SUP>, G B Migliori<SUP>4</SUP>, A Leventhal<SUP>5</SUP><SUP>,6</SUP>
Citation style for this article: Mor Z, Kolb H, Lidji M, Migliori GB, Leventhal A. Tuberculosis diagnostic delay and therapy outcomes of non-national migrants in Tel Aviv, 1998-2008 . Euro Surveill. 2013;18(12)
ii=20433. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20433
Date of submission: 09 July 2013 <HR>http://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab1.jpghttp://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab2.jpghttp://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab3.jpghttp://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab3.jpghttp://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab4.jpghttp://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab5.jpgNon-national migrants have limited access to medical therapy. This study compares diagnostic delay and treatment outcomes of non-insured non-national migrants (NINNM) with insured Israeli citizens (IC) in the Tel Aviv tuberculosis (TB) clinic between 1998 and 2008. Patient delay was the time from symptoms onset to doctor's visit, while system delay was measured from doctor visit to anti-TB therapy administration. We randomly sampled 222 NINNM and 265 IC. NINNM were younger than IC, had lower male to female ratio and fewer smoked. They had less drug/alcohol abuse, more cavitations on chest radiography, longer patient and shorter system delay. Mean patient and system delays of all patients were 25?14 and 79?42 days, respectively. In multivariate analysis, being NINNM, asymptomatic or smoking predicted longer patient delay, while being asymptomatic or having additional co-morbidity predicted longer system delay. Treatment success in sputum smear-positive pulmonary TB NINNM was 81% and 95.7% in IC (p=0.01). Treatment success was not associated with patient or system delay. In multivariate analysis, work security and treatment adherence predicted treatment success. NINNM had longer patient delay and worse therapy outcome, while IC had longer system delay. Both delays should be reduced. NINNM should be informed that TB therapy is free and unlinked with deportation.
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Eurosurveillance, Volume 18, Issue 12, 21 March 2013
Research articles
Tuberculosis diagnostic delay and therapy outcomes of non-national migrants in Tel Aviv, 1998-2008
Research articles
Tuberculosis diagnostic delay and therapy outcomes of non-national migrants in Tel Aviv, 1998-2008
Z Mor (
- Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel
- Ben Gurion University in the Negev, Beer Sheva, Israel
- Tel Aviv Tuberculosis Clinic, Israeli Lung Association, Tel Aviv, Israel
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy
- Department of International Relations, Ministry of Health, Jerusalem, Israel
- Braun School of Public Health, Hebrew University, Jerusalem, Israel
Citation style for this article: Mor Z, Kolb H, Lidji M, Migliori GB, Leventhal A. Tuberculosis diagnostic delay and therapy outcomes of non-national migrants in Tel Aviv, 1998-2008 . Euro Surveill. 2013;18(12)
ii=20433. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20433 Date of submission: 09 July 2013 <HR>http://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab1.jpghttp://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab2.jpghttp://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab3.jpghttp://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab3.jpghttp://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab4.jpghttp://www.eurosurveillance.org/images/dynamic/EE/V18N12/Mor_tab5.jpgNon-national migrants have limited access to medical therapy. This study compares diagnostic delay and treatment outcomes of non-insured non-national migrants (NINNM) with insured Israeli citizens (IC) in the Tel Aviv tuberculosis (TB) clinic between 1998 and 2008. Patient delay was the time from symptoms onset to doctor's visit, while system delay was measured from doctor visit to anti-TB therapy administration. We randomly sampled 222 NINNM and 265 IC. NINNM were younger than IC, had lower male to female ratio and fewer smoked. They had less drug/alcohol abuse, more cavitations on chest radiography, longer patient and shorter system delay. Mean patient and system delays of all patients were 25?14 and 79?42 days, respectively. In multivariate analysis, being NINNM, asymptomatic or smoking predicted longer patient delay, while being asymptomatic or having additional co-morbidity predicted longer system delay. Treatment success in sputum smear-positive pulmonary TB NINNM was 81% and 95.7% in IC (p=0.01). Treatment success was not associated with patient or system delay. In multivariate analysis, work security and treatment adherence predicted treatment success. NINNM had longer patient delay and worse therapy outcome, while IC had longer system delay. Both delays should be reduced. NINNM should be informed that TB therapy is free and unlinked with deportation.