Screening for Subclinical Tuberculosis among International Migrants, Refugees, and Stateless Persons in Brazil
1
1. Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo (EERP/USP), Ribeirão Preto, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A622
ABSTRACT
INTRODUCTION:
The recognition of new clinical spectra of tuberculosis (TB), including incipient TB and subclinical TB, has given rise to new epidemiological paradigms that are not yet well established among international migrants, refugees, and stateless persons (IMRS). Subclinical TB represents an intermediate clinical spectrum between TB infection and active TB and, although asymptomatic, is already considered a form of disease.
OBJECTIVE:
Aim to analyze the prevalence of TB disease and the proportion of subclinical TB among IMRS.
METHODS:
Cross-sectional study conducted in Brazilian cities, namely Belém, Boa Vista, Brasília, Foz do Iguaçu and Ribeirão Preto. TB disease was identified using a rapid molecular test. Subclinical TB was screened based on the absence of symptoms, application of tuberculin skin test (5mm cutoff), and chest radiography. Confirmation was established through laboratory tests and/or radiological findings. IMRS aged 18 years or older and not pregnant were screened.
RESULTS:
958 IMRS were screened, and 14 cases of TB disease were identified, yielding an overall prevalence of 1.46%. Prevalence by city was 1.59% in Belém, 1.63% in Boa Vista, 2.0% in Brasília, 0% in Foz do Iguaçu, and 11% in Ribeirão Preto. Among the 14 identified TB cases, 50% were asymptomatic, corresponding to an overall prevalence of 0.7% in the population and 1.06% in Belém, 0.65% in Boa Vista, 0% in Brasília, 0% in Foz do Iguaçu, and 8.82% in Ribeirão Preto. All cases occurred among Indigenous individuals, predominantly from the Warao ethnic group(93%), women(68%), recipients of social benefits(92%), with a mean duration of residence in Brazil of four years. Six of the seven cases in both symptomatic and asymptomatic forms reported having had contact with a person with TB.
CONCLUSIONS:
TB disease, and particularly subclinical tuberculosis, represents a substantial burden among IMRS and requires adapted, culturally sensitive clinical protocols for screening across the spectrum.
The recognition of new clinical spectra of tuberculosis (TB), including incipient TB and subclinical TB, has given rise to new epidemiological paradigms that are not yet well established among international migrants, refugees, and stateless persons (IMRS). Subclinical TB represents an intermediate clinical spectrum between TB infection and active TB and, although asymptomatic, is already considered a form of disease.
OBJECTIVE:
Aim to analyze the prevalence of TB disease and the proportion of subclinical TB among IMRS.
METHODS:
Cross-sectional study conducted in Brazilian cities, namely Belém, Boa Vista, Brasília, Foz do Iguaçu and Ribeirão Preto. TB disease was identified using a rapid molecular test. Subclinical TB was screened based on the absence of symptoms, application of tuberculin skin test (5mm cutoff), and chest radiography. Confirmation was established through laboratory tests and/or radiological findings. IMRS aged 18 years or older and not pregnant were screened.
RESULTS:
958 IMRS were screened, and 14 cases of TB disease were identified, yielding an overall prevalence of 1.46%. Prevalence by city was 1.59% in Belém, 1.63% in Boa Vista, 2.0% in Brasília, 0% in Foz do Iguaçu, and 11% in Ribeirão Preto. Among the 14 identified TB cases, 50% were asymptomatic, corresponding to an overall prevalence of 0.7% in the population and 1.06% in Belém, 0.65% in Boa Vista, 0% in Brasília, 0% in Foz do Iguaçu, and 8.82% in Ribeirão Preto. All cases occurred among Indigenous individuals, predominantly from the Warao ethnic group(93%), women(68%), recipients of social benefits(92%), with a mean duration of residence in Brazil of four years. Six of the seven cases in both symptomatic and asymptomatic forms reported having had contact with a person with TB.
CONCLUSIONS:
TB disease, and particularly subclinical tuberculosis, represents a substantial burden among IMRS and requires adapted, culturally sensitive clinical protocols for screening across the spectrum.
| eISSN: | 2654-1459 |
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