International Journal of Tuberculosis and Lung Disease
Volume 21, Issue 9, 2017, Pages 965-976

Effectiveness and cost-effectiveness of screening migrants for active tuberculosis and latent tuberculous infection (Review)

Zenner D.* , Hafezi H. , Potter J. , Capone S. , Matteelli A.
  • a Centre for Infectious Disease Surveillance and Control, Public Health England Colindale, London, United Kingdom, University College London, Institute of Global Health, London, United Kingdom, Imperial College London, National Institute for Health Research, Health Protection Research Unit in Respiratory Infections, London, United Kingdom
  • b Centre for Infectious Disease Surveillance and Control, Public Health England Colindale, London, United Kingdom
  • c Barts and the London School of Medicine and Dentistry, Blizard Institute, Centre for Primary Care and Public Health, London, United Kingdom
  • d Department of Clinical and Experimental Sciences, Universit À degli Studi di Brescia, Brescia, Italy
  • e Department of Clinical and Experimental Sciences, Universit À degli Studi di Brescia, Brescia, Italy

Abstract

With the advent of the World Health Organization End TB strategy, there has been renewed interest in screening for active tuberculosis (TB), and particularly latent tuberculous infection (LTBI). In low-incidence countries, a high proportion of TB cases are notified among migrants, which often occurs due to LTBI reactivation.We aimed to review the effectiveness and cost-effectiveness of screening migrants for active TB LTBI to inform and support the TB elimination strategy in low-incidence countries. We carried out a narrative review of English language articles published between 1 January 2000 and 31 June 2016 using the PubMed database. All studies that described the effectiveness or cost-effectiveness of active TB or LTBI screening amongmigrantswere included.We identified 55 studies, and included 40 for the effectiveness of screening, 11 for cost-effectiveness and 4 that reported both. Screening for active TB can be effective and costeffective depending on the setting, target group and screening approach. Pre-entry screening programmes have some impact on the epidemiology of the receiving countries. The effectiveness and cost-effectiveness of LTBI screening as predicted in mathematical models is also highly setting-specific, with best potential results achieved if screening is restricted to high-risk groups and/ or to migrants from high-burden countries. © 2017 The Union.

Author Keywords

Cost-effectiveness Effectiveness Public health impact LTBI screening TB case finding

Index Keywords

monotherapy sputum smear Cost benefit analysis mass screening Observational Studies as Topic economics Randomized Controlled Trials as Topic randomized controlled trial (topic) predictive value human diagnostic accuracy interferon gamma release assay sputum culture priority journal quality adjusted life year mathematical model screening Humans migrant latent tuberculosis tuberculosis Review observational study diagnostic test accuracy study high risk population placebo Incidence sensitivity and specificity tuberculin test migration isoniazid enzyme linked immunospot assay thorax radiography Transients and Migrants tuberculosis rapid test rifampicin isoniazid plus rifampicin systematic review cost-benefit analysis clinical effectiveness cost effectiveness analysis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85018884305&doi=10.5588%2fijtld.16.0935&partnerID=40&md5=5482bedd75b461d79e443cc208881706
DOI: 10.5588/ijtld.16.0935
ISSN: 10273719
Cited by: 11
Original Language: English