E-DETECT partners from the San Raffaele Hospital (OSR) and the University of Brescia (UNIBS) have been working with various organisations in Italy to establish new processes and methods of tuberculosis screening for migrants.

Dr Lucia Barcellini of OSR describes their activities to date.

“In the first year of E-DETECT project, we first focused our attention on the recognition of the main requirements and obstacles associated with TB screening activities among migrants in Italy, and to identifying possible partners.

“At present, there is no national surveillance system for TB among the migrant population.  Sicily is the main point of arrival in Italy for migrants on the Central Mediterranean route.  There it is observed the absence of defined roles and responsibility in regards to TB screening, as well as the fragmentation of data collection.

“We initially concentrated on organising several meetings with government authorities in Sicily (Prefettura di Catania), central health authorities (MoH, Usmaf), local health authorities, a non-profit organisation (Italian Red Cross) and local health-care providers (Garibaldi Hospital in Catania).  Eventually, we agreed to evaluate a multi-step strategy based on active TB screening by spot sputum collection and rapid microbiological diagnosis in symptomatic patients.

“Screening activities started at the end of November 2016, in the C.A.R.A. (Centre for Accommodation of Asylum-seeker) of Mineo (Catania).  A team from the San Raffaele Hospital (OSR), visited the centre once a month to perform active TB screening.  Since April 2017, new screening sites have been added in Sicily: the CSPA in Lampedusa (Agrigento) and the emergency reception center (CAS) of Villa Sikania in Agrigento.

“Moving outside Sicily, we were also able to perform screenings in the first aid and reception centre (CSPA) in Bresso (Milan), thanks to the collaboration with the Italian Red Cross.  We currently plan to expand screening to the CAS of Cascina Gobba in Milan.

“These interventions gave us the opportunity to get a better understanding of what part of the migration chain is most suitable for performing TB screening activities.  It additionally enabled us to meet new possible partners that could facilitate long-term sustainability of the intervention.  To date, we met almost 2,500 migrants and detected 11 case of active TB.  Microbiological analysis is still ongoing for around 400 patients.”

Dr Lucia Barcellini (left) and Dr Giovanna Stancanelli (right) are pictured here with a young migrant from Eritrea who was diagnosed with active TB at his E-DETECT screening appointment.  He is now receiving treatment at Catania hospital.

(Top image: Giovanna, left, and Lucia, right, with newly-arrived refugees from Syria.)