Læknablaðið - 15.12.1997, Blaðsíða 24

810
LÆKNABLAÐIÐ 1997; 83
Berklar hjá innflytjendum á íslandi
Stefán Þorvaldsson1*, Þorsteinn Blöndal1,2’, Haraldur Briem3’
Þorvaldsson S, Blöndal Þ, Bricni H
Tuberculous infcction and tuberculosis in the foreign
born in Iccland
Læknablaðið 1997; 83: 810-6
Objective: The purpose of the study was to find the
incidence and prevalence of tuberculosis among the
foreign-born in Iceland.
Material and methods: The study material was ob-
tained from (a) the National TB register and (b) the
files of the Immigration Office on recidency appli-
cants in 1995.
Results: In 1975-1996 there were 32 cases of TB in
the foreign-born out of a total of 468. The propor-
tion of cases among the foreign-born rose signif-
icantly during the period (p<0.001). In 22 years the
incidence of TB among the foreign-born was 18.0
but 8.4 among those born in Iceland (p<0.001). The
incidence of TB in Asian-born was 173.7, or 21 times
that among those born in Iceland (p<0.001). The
second highest incidence (18.8) was in those born in
North and South America. Tuberculosis usually ap-
peared within five years of immigration. During
1995 the 559 applicants for recidence permit provid-
ed health certificates. Of these 363 had a tuberculin
skin test (TST) and 42% were positive. The corre-
sponding figure for those born in Africa was 68%, in
Asia 58% and in East Europa 50%. Most of those
with positive TST had a chest x-ray but also 23% of
the others. 26.2% had neither a TST nor a chest
x-ray but still received a health certificate. Only
33% of those positive received isoniazide to elim-
Frá 1,Heilsuverndarstöö Reykjavíkur, 2)lyflækningadeild
Landspítalans, 3|Sjúkrahúsi Reykjavíkur. Fyrirspurnir,
bréfaskipti: Stefán Þorvaldsson, Heilsuverndarstöð Reykja-
víkur, 101 Reykjavík.
inate infection and 88% of these completed at least
six months of isoniazide treatment.
Conclusion: A TST is an indispensable part of health
screening for immigrants and also a chest x-ray when
appropriate. Treatment of TB infection should be
used more often.
Key words: tuberculosis, tuberculous infection, immigra-
tion.
Ágrip
Tilgangur: Tilgangur rannsóknar var að
finna nýgengi berkla meðal innflytjenda á ís-
landi.
Efniviður og aðferðir: Efniviður var annars
vegar sóttur í berklaskrá og hins vegar í skrá
Útlendingaeftirlitsins um þá sem sóttu um
dvalarleyfi árið 1995.
Niðurstöður: Á árunum 1975-1996 greindust
468 berklatilfelli á íslandi, þar af 32 berklatil-
felli meðal innflytjenda. Hlutfall innflytjenda
meðal berklaveikra jókst marktækt á tímabil-
inu (p<0,001). Nýgengi berklaveiki meðal inn-
flytjenda var 18,0 á 22 árum en meðal inn-
fæddra íslendinga 8,4 (p<0,001). Nýgengi
meðal innflytjenda frá Asíu var 173,7 eða 21
sinnum hærra en meðal innfæddra Islendinga
(p<0,001) en þar á eftir komu innflytjendur frá
ríkjum Ameríku með nýgengi 18,8. Berkla-
veiki kom venjulega fram innan fimm ára frá
komu til landsins. Árið 1995 framvísuðu 559
manns sem sóttu um dvalarleyfi læknisvott-
orði. Af þeim fór rúmur fjórðungur (26,2%)
hvorki í berklapróf né lungnamynd. Af 363
berklaprófuðum umsækjendum um dvalarleyfi
voru 42% jákvæðir. Samsvarandi tölur fyrir
fólk frá Afríku voru 68%, Asíu 58% og Aust-
ur-Evrópu 50%. Flestir jákvæðra fóru í