HAL Id: hal-03049164
https://hal.uca.fr/hal-03049164
Submitted on 9 Dec 2020
HAL is a multi-disciplinary open access
archive for the deposit and dissemination of
sci-entific research documents, whether they are
pub-lished or not. The documents may come from
teaching and research institutions in France or
abroad, or from public or private research centers.
L’archive ouverte pluridisciplinaire HAL, est
destinée au dépôt et à la diffusion de documents
scientifiques de niveau recherche, publiés ou non,
émanant des établissements d’enseignement et de
recherche français ou étrangers, des laboratoires
publics ou privés.
Tuberculosis screening for foreign students change: good
saving and bad idea?
Laurent Gerbaud, B Chabanas, A Perrève, Bureau de l’Adssu
To cite this version:
Laurent Gerbaud, B Chabanas, A Perrève, Bureau de l’Adssu. Tuberculosis screening for foreign
students change: good saving and bad idea?. European Journal of Public Health, Oxford University
Press (OUP): Policy B - Oxford Open Option D, 2019, 29 (Supplement_4), pp.323.
�10.1093/eur-pub/ckz187.070�. �hal-03049164�
Key messages:
Economic burden of CVD in France is high: 10% of
healthcare expenditure.
Implementation of public health policy to prevent CVD and
control risk factors must be a priority.
4.R. Infectious diseases control between policy
and epidemiology
Tuberculosis screening for foreign students change: good saving and bad idea?
Laurent Gerbaud
L Gerbaud1,2,3, B Chabanas1, A Perre`ve1, Bureau de l’ADSSU3 1Service de Sante´ Universitaire, Universite´ Clermont Auvergne,
Clermont-Ferrand, France
2Service de sante´ publique, Universite´ Clermont Auvergne, CHU
Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Clermont-Ferrand, France
3ADSSU, Maison des Universite´s, Paris, France
Contact: [email protected]
Issue:
There was a mandatory screening of tuberculosis (TB) for the 60.000 foreign students (out of European Union) annually newcomer in France. It was organized by screening centers of the Office of Immigration and Integration, a State agency. There was a link with university students’ health services (USHS) by systematic exchange of data, and sometimes the USHS was in charge of this screening and financed for that. In March 2016, a law, applied since January 2017, stopped this obligation, and transferred the responsibility of a ‘‘preventive survey’’ to USHS, without any means and financing. Problem:
As the decision was made without any data, thanks to the national network of UHSH, we made a brief national survey showing a 2,7 to 7,9/1.000 incidence, from year to year, 40% being active. About 50% of the cases came from North Africa and China. These data did not changed the decision, and we present its consequences in one French University, which was a previous TBI screening center. We computed all the cases of TB known in our USHS, since 2010, completed by the data form health authorities.
Results:
Since screening is not anymore mandatory we faced a global refusal from Chinese and Moroccan students arguing that there was no TB in their country. Number of foreign students and their origin were approximately stable from 2010 to 2016, and mean TB incidence was 1,97/1.000. Students from China and North Africa represented half of the cases and 40% were latent TB. Since January 2017, TB incidence lowers to 1,51/ 1.000. Latent TB represent less than ¼, and there was no more cases screened from North Africa and China, while there was no change in foreign students origins, showing a significant degradation of screening effectiveness.
Lessons:
The main reason for screening cessation was to save public money. Due to important lack of knowledge among French state authorities, we couldn’t change a decision which threatens the TB epidemic control.
Key messages:
Cost saving policy reduced the effectiveness of tuberculosis screening.
Health policy decisions may not take into account epidemiologic objectives.
Healthcare workers and measles outbreaks in Italy: is it time to act? A systematic review
Corrado De Vito
V Baccolini1, A Sindoni1, G Adamo1, A Rosso1, A Massimi1, E Pitini1, C
De Vito1, C Marzuillo1, P Villari1
1Department of Public Health and Infectious Diseases, Sapienza University
of Rome, Rome, Italy
Contact: [email protected]
Background:
Despite healthcare workers (HCWs) vaccination against measles is strongly recommended in Europe, many studies showed their low vaccination coverage and a significant involvement in hospital and community outbreaks. The aim of this systematic review was to analyze the available evidence on HCW role in measles outbreaks and identify the epidemiological characteristics of the transmission patterns related to HCW infection.
Methods:
PubMed, Scopus and ISI Web of Science were searched to detect the measles outbreaks occurred in Italy and involving at least one HCW. English or Italian records were considered eligible. The quality assessment was performed using the ORION checklist. We also analyzed national or regional measles reports and the Measles outbreaks reporting forms that are annually submitted to the World Health Organization (WHO) of the period 2014-2018.
Results:
Twenty-one articles were identified in the literature search and were in general of good quality. Of these, six were regional or Italian reports, two referred to one city, 13 were single outbreak reports. The national data showed that the number of infected HCWs increases with the rise of the total number of cases. A total of 72 descriptions of measles outbreaks were retrieved from the WHO reports. The vast majority was confined to the hospital or started at the hospital and spread in the community. The index cases were mainly patients seeking care for measles-related symptoms but, in the last years, a growing number of infected HCWs was identified as infection source. Similarly, the number of outbreaks with more than one infected HCW recorded a small increase over time.
Conclusions:
HCWs play a critical role in measles transmission especially in hospital outbreaks, which are significantly costly and disruptive for the healthcare delivery quality and safety. Vaccination policy aiming at increasing their immunization rate is crucial to limit the virus spread and the economic impact on the institutions. Key messages:
In spite of the remarkable progress, measles elimination in
Italy is far from being met and the virus transmission in healthcare settings is increasingly notified.
Vaccination policies aiming at increasing HCW
immuniza-tion coverages are essential.
Monitoring measles outbreaks using emergency department data in France
Guilhem Noel
G Noel1,2, F Franke3, C Forgeot4, J Piarroux1, G Viudes5, C
Caserio-Scho¨nemann4
1Pediatric Emergency Department, APHM, Marseille, France 2PACA Regional Emergency Department Observatory, Ies-Sud, Hye`res,
France
3Regional office (Provence-Alpes-Coˆte d’Azur and Corsica), Sante´ Publique
France, Marseille, France
4Data Science Division, Sante´ Publique France, Saint-Maurice, France 5Studies and Analysis, Federation of Observatories for Emergency
Medecine, Hye`res, France Contact: [email protected]
Background:
Measles’ outbreaks still occur in industrialised countries and reactive monitoring of the disease is needed. In France,
12th European Public Health Conference 2019–01: Poster Walks 323
