The Lancet Infectious Diseases
Volume 16, Issue 8, 2016, Pages 962-970
Prevalence of and risk factors for active tuberculosis in migrants screened before entry to the UK: a population-based cross-sectional study (Article) (Open Access)
Aldridge R.W.* ,
Zenner D. ,
White P.J. ,
Muzyamba M.C. ,
Loutet M. ,
Dhavan P. ,
Mosca D. ,
Hayward A.C. ,
Abubakar I.
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a
Centre for Public Health Informatics, Institute of Health Informatics, University College London, London, United Kingdom, The Farr Institute of Health Informatics Research, University College London, London, United Kingdom, Centre for Infectious Disease Epidemiology, University College London, London, United Kingdom, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
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b
Centre for Infectious Disease Epidemiology, University College London, London, United Kingdom, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
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c
Modelling and Economics Unit, Public Health England, London, United Kingdom, MRC Centre for Outbreak Analysis and Modelling, National Institute for Health Research Health Protection Research Unit in Modelling Methodology, Imperial College London, London, United Kingdom
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d
Centre for Infectious Disease Epidemiology, University College London, London, United Kingdom, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
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e
Centre for Infectious Disease Epidemiology, University College London, London, United Kingdom, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
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f
Migration Health Division, International Organization for Migration, Geneva, Switzerland
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g
Migration Health Division, International Organization for Migration, Geneva, Switzerland
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h
Centre for Public Health Informatics, Institute of Health Informatics, University College London, London, United Kingdom, The Farr Institute of Health Informatics Research, University College London, London, United Kingdom
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i
Centre for Infectious Disease Epidemiology, University College London, London, United Kingdom, Medical Research Council (MRC) Clinical Trials Unit, University College London, London, United Kingdom, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
Abstract
Background An increasing number of countries with low incidence of tuberculosis have pre-entry screening programmes for migrants. We present the first estimates of the prevalence of and risk factors for tuberculosis in migrants from 15 high-incidence countries screened before entry to the UK. Methods We did a population-based cross-sectional study of applicants for long-term visas who were screened for tuberculosis before entry to the UK in a pilot programme between Oct 1, 2005, and Dec 31, 2013. The primary outcome was prevalence of bacteriologically confirmed tuberculosis. We used Poisson regression to estimate crude prevalence and created a multivariable logistic regression model to identify risk factors for the primary outcome. Findings 476 455 visa applicants were screened, and the crude prevalence of bacteriologically confirmed tuberculosis was 92 (95% CI 84–101) per 100 000 individuals. After adjustment for age and sex, factors that were strongly associated with an increased risk of bacteriologically confirmed disease at pre-entry screening were self-report of close or household contact with an individual with tuberculosis (odds ratio 11·6, 95% CI 7·0–19·3; p<0·0001) and being an applicant for settlement and dependant visas (1·3, 1·0–1·6; p=0·0203). Interpretation Migrants reporting contact with an individual with tuberculosis had the highest risk of tuberculosis at pre-entry screening. To tackle this disease burden in migrants, a comprehensive and collaborative approach is needed between countries with pre-entry screening programmes, health services in the countries of origin and migration, national tuberculosis control programmes, and international public health bodies. Funding Wellcome Trust, Medical Research Council, and UK National Institute for Health Research. © 2016 Aldridge et al. Open Access article distributed under the terms of CC BY
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-84962159612&doi=10.1016%2fS1473-3099%2816%2900072-4&partnerID=40&md5=cead909e5eea968ab7320e85c1338b05
DOI: 10.1016/S1473-3099(16)00072-4
ISSN: 14733099
Cited by: 25
Original Language: English