Latent tuberculosis infection in young refugees in Germany a multicentre, cross-sectional study

Incidence rates of tuberculosis (TB) in children in Germany have been on the rise since 2008, especially among foreign-born individuals. Significant numbers of refugees during 2014-2016 suggest that TB incidence rates are likely to continue to rise. The implementation of an adequate screening strategy for TB is challenging. In order to setup effective and reliable measures for comprehensive TB screening in children below the age of 15 years, a multicentre, cross-sectional study was performed from September 2015 to October 2016. In 7 refugee camps in two different urban settings (Hamburg and Bochum) of Germany, a total of 1046 children, aged between 6 months and 15 years, were immunologically tested for tuberculosis utilizing the Mantoux tuberculin skin test (TST) as well as the interferon gamma release assay (IGRA). A pre-screening questionnaire included sociodemographic data (e.g. country of birth, country of origin of the child’s parents as well as migratory route and its respective duration), health status and Bacille Calmette-Guérin (BCG)-vaccination status. In Hamburg 552 out of 802 children were examined. 156 omitted due to various reasons. In Bochum 650 out of 873 children were screened. In line with expectations, 5,7 per cent of young asylum seekers were tested positively, underlining that they represent a vulnerable group for tuberculosis infection. Consequently universal screening should be implemented.