European Respiratory Journal
Volume 34, Issue 5, 2009, Pages 1180-1189

Migrant tuberculosis screening in the EU/EEA: Yield, coverage and limitations (Review) (Open Access)

Klinkenberg E. , Manissero D.* , Semenza J.C. , Verver S.
  • a KNCV Tuberculosis Foundation, The Hague, Netherlands, Dept. of Infectious Disease, Tropical Medicine and AIDS, Center for Infection and Immunity Amsterdam, University of Amsterdam, Amsterdam, Netherlands
  • b Scientific Advice Unit, European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
  • c Scientific Advice Unit, European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
  • d KNCV Tuberculosis Foundation, The Hague, Netherlands, Dept. of Infectious Disease, Tropical Medicine and AIDS, Center for Infection and Immunity Amsterdam, University of Amsterdam, Amsterdam, Netherlands

Abstract

A systematic literature review was performed with the objective of assessing the effectiveness of tuberculosis (TB) screening methods and strategies in migrants in European Union/European Economic Area (including Switzerland) countries. Extracted data on yield and coverage were used as indicators of effectiveness. Reported yields varied considerably between studies and countries. Considering only the 14 studies representative of national screening programmes, a median yield of TB disease of 0.18% (interquartile range 0.10-0.35%) was reported. The data did not indicate differences in effectiveness between the three main strategies: 1) screening at port of entry; 2) screening just after arrival in reception/holding centres; and 3) screening in the community following arrival in European Union countries. The variation seen probably reflects variation in risk factors for TB, in particular the composition of the migrants entering the country. Recommendations include the need for improved data for guiding the optimal frequency and duration of screening; assessment and improvement of cost-effectiveness; access to healthcare for migrants, including illegal migrants; ensuring a continuum of care for those screened; and consideration of screening for latent TB infection with caution. Finally, screening should be a component of a wider approach, rather than a stand-alone intervention. Copyright©ERS Journals Ltd 2009.

Author Keywords

Screening Coverage tuberculosis Systematic review migrant Yield

Index Keywords

latent tuberculosis priority journal tuberculosis risk factor Review communicable disease control Transients and Migrants European Union mass screening systematic review screening human Humans Refugees migration health care access
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-70350439108&doi=10.1183%2f09031936.00038009&partnerID=40&md5=f783f69c4c2ec442466e988f3c651d50
DOI: 10.1183/09031936.00038009
ISSN: 09031936
Cited by: 95
Original Language: English