[Screening contacts for latent tuberculosis infection (LTBI) using an interferon test in Paris in 2009]. / Dépistage de l'infection tuberculeuse latente (ITL) à Paris à l'aide d'un test interféron chez des sujets contact en 2009.

There are two reasons for screening contacts: one is to identify cases of secondary tuberculosis disease (TB) and the other is to identify new cases of latent tuberculosis infection (LTBI). The tuberculin skin test (TST) and the interferon-gamma-release assay (IGRA) have their limitations when used for the detection of LTBI. They neither allow a definite diagnosis of LTBI nor provide information as to the date of onset. The present study was observational, multi-centre (four centers) and retrospective. Six hundred and one contacts were included. The results of the QFT test showed 88 positive (15 %). Among the 144 index cases, all presented with pulmonary disease and 89 cases were sputum positive. In our series, 101 contacts belonged to the family circle. The four factors that had a significant positive impact on the result of the QFT test were: increasing age, the region of birth of the contact (high incidence areas), both of which may indicate old infection, while contact within the family and sputum positivity of the index case probably indicate recent infection. Only sputum positivity influenced the decision to treat the LTBI. We propose a tool aimed at facilitating the decision making process in QFT positive cases. Estimation of the duration of LTBI should help the physician to decide on the need for preventative treatment as well as a search for factors that increase the risk of progression to TB disease.

[Schistosoma haematobium among immigrants consulting in municipal free clinics in Paris in 2003]. / La schistosomose urinaire chez des migrants ayant consulté dans des centres médico-sociaux de Paris en 2003.

The "Consultations de Diagnostic et d'Orientation" (CDO) are free medical consultations for precarious populations, proposed by the Health Department of Paris. More than two-thirds of the CDO patients come from Sub-Saharan Africa. Schistosoma haematobium (SH) is one of the most frequent infectious diseases detected within CDO. More than a thousand people have consulted for the first time in CDO in 2003 in one of the municipal free Clinics which proposes this service. Parasitologic test of urine has been performed among 220 patients and found 24 positive results: viable eggs of SH (10.8%). All 24 patients are male, most of them are under 35 years-old and come from the region of the Senegal River that lies in the junction of Mali, Senegal and Mauritania. We want to remind physicians in non-tropical setting to think of SH when they see a patient originating from Africa. To ask him if he presents haematuria and if not, to prescribe a parasitologic test of urine. If all patients from endemic regions had undergone this screening in 2003, we would have detected about 20 more cases of SH. If treated early enough, it could avoid severe uronephrological complications, which are rare but represent a high health care cost (bladder tumor, renal failure).