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Abstract

Background

The foreign-born population make up an increasing and large proportion of tuberculosis (TB) cases in European Union/European Economic Area (EU/EEA) low-incidence countries and challenge TB elimination efforts. We conducted a systematic review to determine effectiveness (yield and performance of chest radiography (CXR) to detect active TB, treatment outcomes and acceptance of screening) and a second systematic review on cost-effectiveness of screening for active TB among migrants living in the EU/EEA. We identified six systematic reviews, one report and three individual studies that addressed our aims. CXR was highly sensitive (98%) but only moderately specific (75%). The yield of detecting active TB with CXR screening among migrants was 350 per 100,000 population overall but ranged widely by host country (110–2,340), migrant type (170–1,192), TB incidence in source country (19–336) and screening setting (220–1,720). The CXR yield was lower (19.6 vs 336/100,000) and the numbers needed to screen were higher (5,076 vs 298) among migrants from source countries with lower TB incidence (≤ 50 compared with ≥ 350/100,000). Cost-effectiveness was highest among migrants originating from high (> 120/100,000) TB incidence countries. The foreign-born had similar or better TB treatment outcomes than those born in the EU/EEA. Acceptance of CXR screening was high (85%) among migrants. : Screening programmes for active TB are most efficient when targeting migrants from higher TB incidence countries. The limited number of studies identified and the heterogeneous evidence highlight the need for further data to inform screening programmes for migrants in the EU/EEA.

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2018-04-05
2024-12-21
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References

  1. European Centre for Disease Prevention and Control (ECDC). Guidance on tuberculosis control in vulnerable and hard-to-reach populations. Stockholm: ECDC; 2016. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/TB-guidance-interventions-vulnerable-groups.pdf
  2. European Centre for Disease Prevention and Control (ECDC). Progressing towards TB elimination. Stockholm: ECDC; 2010. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/101111_SPR_Progressing_towards_TB_elimination.pdf
  3. Lönnroth K, Migliori GB, Abubakar I, D’Ambrosio L, de Vries G, Diel R, et al. Towards tuberculosis elimination: an action framework for low-incidence countries. Eur Respir J. 2015;45(4):928-52. PMID: 25792630 
  4. World Health Organisation (WHO). Towards TB elimination. An action framework for low-incidence countries. Geneva: WHO; 2014. Available from: http://apps.who.int/iris/bitstream/10665/132231/1/9789241507707_eng.pdf?ua=1
  5. European Centre for Disease Prevention and Control (ECDC)/World Health Organization Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017. Stockholm: ECDC; 2017. Available from: https://ecdc.europa.eu/sites/portal/files/documents/ecdc-tuberculosis-surveillance-monitoring-Europe-2017-WEB.pdf
  6. Ködmön C, Zucs P, van der Werf MJ. Migration-related tuberculosis: epidemiology and characteristics of tuberculosis cases originating outside the European Union and European Economic Area, 2007 to 2013. Euro Surveill. 2016;21(12):30164.  https://doi.org/10.2807/1560-7917.ES.2016.21.12.30164  PMID: 27039665 
  7. Eurostat. Migration and migrant population statistics. Luxembourg: European Commission. [Accessed: 30 Jan 2017]. Available from: http://ec.europa.eu/eurostat/statistics-explained/index.php/Migration_and_migrant_population_statistics
  8. International Organization for Migration (IOM). Migration flows - Europe. Geneva: IOM. [Accessed: 15 May 2017]. Available from: http://migration.iom.int/europe/
  9. Eurostat. European social statistics. Luxembourg; 2013.
  10. World Health Organisation (WHO) Strategic and Technical Advisory Group for TB. (STAG-TB). Use of high burden country lists for TB by WHO in the post-2015 era. Geneva: WHO; 2015. Available from: http://www.who.int/tb/publications/global_report/high_tb_burdencountrylists2016-2020.pdf
  11. Hollo V, Kotila SM, Ködmön C, Zucs P, van der Werf MJ. The effect of migration within the European Union/European Economic Area on the distribution of tuberculosis, 2007 to 2013. Euro Surveill. 2016;21(12):30171.  https://doi.org/10.2807/1560-7917.ES.2016.21.12.30171  PMID: 27035746 
  12. Hollo V, Beauté J, Ködmön C, van der Werf MJ. Tuberculosis notification rate decreases faster in residents of native origin than in residents of foreign origin in the EU/EEA, 2010 to 2015. Euro Surveill. 2017;22(12):30486.  https://doi.org/10.2807/1560-7917.ES.2017.22.12.30486  PMID: 28367798 
  13. Pareek M, Greenaway C, Noori T, Munoz J, Zenner D. The impact of migration on tuberculosis epidemiology and control in high-income countries: a review. BMC Med. 2016;14(1):48.  https://doi.org/10.1186/s12916-016-0595-5  PMID: 27004556 
  14. Pareek M, Baussano I, Abubakar I, Dye C, Lalvani A. Evaluation of immigrant tuberculosis screening in industrialized countries. Emerg Infect Dis. 2012;18(9):1422-9.  https://doi.org/10.3201/eid1809.120128  PMID: 22931959 
  15. Kunst H, Burman M, Arnesen TM, Fiebig L, Hergens MP, Kalkouni O, et al. Tuberculosis and latent tuberculous infection screening of migrants in Europe: comparative analysis of policies, surveillance systems and results. Int J Tuberc Lung Dis. 2017;21(8):840-51.  https://doi.org/10.5588/ijtld.17.0036  PMID: 28786791 
  16. Schünemann HJ, Wiercioch W, Brozek J, Etxeandia-Ikobaltzeta I, Mustafa RA, Manja V, et al. GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo development of trustworthy recommendations: GRADE-ADOLOPMENT. J Clin Epidemiol. 2017;81:101-10.  https://doi.org/10.1016/j.jclinepi.2016.09.009  PMID: 27713072 
  17. Pottie K, Mayhew AD, Morton RL, Greenaway C, Akl EA, Rahman P, et al. Prevention and assessment of infectious diseases among children and adult migrants arriving to the European Union/European Economic Association: a protocol for a suite of systematic reviews for public health and health systems. BMJ Open. 2017;7(9):e014608.  https://doi.org/10.1136/bmjopen-2016-014608  PMID: 28893741 
  18. Moher D, Liberati A, Tetzlaff J, Altman DGPRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264-9, W64.  https://doi.org/10.7326/0003-4819-151-4-200908180-00135  PMID: 19622511 
  19. Woolf S, Schünemann HJ, Eccles MP, Grimshaw JM, Shekelle P. Developing clinical practice guidelines: types of evidence and outcomes; values and economics, synthesis, grading, and presentation and deriving recommendations. Implement Sci. 2012;7(1):61.  https://doi.org/10.1186/1748-5908-7-61  PMID: 22762158 
  20. Kahwati LC, Feltner C, Halpern M, Woodell CL, Boland E, Amick HR, et al. Primary care screening and treatment for latent tuberculosis infection in adults: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2016;316(9):970-83.  https://doi.org/10.1001/jama.2016.10357  PMID: 27599332 
  21. Greenaway C, Sandoe A, Vissandjee B, Kitai I, Gruner D, Wobeser W, et al. Tuberculosis: evidence review for newly arriving immigrants and refugees. CMAJ. 2011;183(12):E939-51.  https://doi.org/10.1503/cmaj.090302  PMID: 20634392 
  22. Shea BJ, Hamel C, Wells GA, Bouter LM, Kristjansson E, Grimshaw J, et al. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol. 2009;62(10):1013-20.  https://doi.org/10.1016/j.jclinepi.2008.10.009  PMID: 19230606 
  23. Wells G, Shea B, O’Connell B, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa: Ottawa Hospital Research Institute. [Accessed: Oct 2016]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
  24. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383-94.  https://doi.org/10.1016/j.jclinepi.2010.04.026  PMID: 21195583 
  25. Aldridge RW, Yates TA, Zenner D, White PJ, Abubakar I, Hayward AC. Pre-entry screening programmes for tuberculosis in migrants to low-incidence countries: a systematic review and meta-analysis. Lancet Infect Dis. 2014;14(12):1240-9.  https://doi.org/10.1016/S1473-3099(14)70966-1  PMID: 25455991 
  26. Alonso-Coello P, Oxman AD, Moberg J, Brignardello-Petersen R, Akl EA, Davoli M, et al. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. BMJ. 2016;353:i2089.  https://doi.org/10.1136/bmj.i2089  PMID: 27365494 
  27. Drummond MFSM, Torrance GW, O’Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes. 2nd edition. New York: Oxford University Press; 1997. 396 p.
  28. Arshad S, Bavan L, Gajari K, Paget SN, Baussano I. Active screening at entry for tuberculosis among new immigrants: a systematic review and meta-analysis. Eur Respir J. 2010;35(6):1336-45.  https://doi.org/10.1183/09031936.00054709  PMID: 19840970 
  29. Klinkenberg E, Manissero D, Semenza JC, Verver S. Migrant tuberculosis screening in the EU/EEA: yield, coverage and limitations. Eur Respir J. 2009;34(5):1180-9.  https://doi.org/10.1183/09031936.00038009  PMID: 19880618 
  30. Van’t Hoog A, Langendam M, Mitchell E, Cobelens F, Sinclair D, Leeflang M, et al. A systematic review of the sensitivity and specificity of symptom-and chest-radiography screening for active pulmonary tuberculosis in HIV-negative persons and persons with unknown HIV status. Geneva: World Health Organization; 2013. Available from: http://www.who.int/tb/Review2Accuracyofscreeningtests.pdf?ua=1
  31. Pinto LM, Pai M, Dheda K, Schwartzman K, Menzies D, Steingart KR. Scoring systems using chest radiographic features for the diagnosis of pulmonary tuberculosis in adults: a systematic review. Eur Respir J. 2013;42(2):480-94.  https://doi.org/10.1183/09031936.00107412  PMID: 23222871 
  32. Mitchell EMH, Shapiro A, Golub J, Kranzer K, Portocarrero AV, Najlis CA, et al. Acceptability of TB screening among at-risk and vulnerable groups: a systematic qualitative/quantitative literature metasynthesis. Geneva: World Health Organization; 2013. Available from: http://www.who.int/entity/tb/Review4aAcceptabilityofscreeningRISK_GROUPS.pdf?ua=1
  33. Schwartzman K, Menzies D. Tuberculosis screening of immigrants to low-prevalence countries. A cost-effectiveness analysis. Am J Respir Crit Care Med. 2000;161(3 Pt 1):780-9.  https://doi.org/10.1164/ajrccm.161.3.9902005  PMID: 10712322 
  34. Dasgupta K, Schwartzman K, Marchand R, Tennenbaum TN, Brassard P, Menzies D. Comparison of cost-effectiveness of tuberculosis screening of close contacts and foreign-born populations. Am J Respir Crit Care Med. 2000;162(6):2079-86.  https://doi.org/10.1164/ajrccm.162.6.2001111  PMID: 11112118 
  35. Oxlade O, Schwartzman K, Menzies D. Interferon-gamma release assays and TB screening in high-income countries: a cost-effectiveness analysis. Int J Tuberc Lung Dis. 2007;11(1):16-26. PMID: 17217125 
  36. van der Werf MJ, Zellweger JP. Impact of migration on tuberculosis epidemiology and control in the EU/EEA. Euro Surveill. 2016;21(12):30174.  https://doi.org/10.2807/1560-7917.ES.2016.21.12.30174  PMID: 27035852 
  37. D’Ambrosio L, Centis R, Dara M, Solovic I, Sulis G, Zumla A, et al. European policies in the management of tuberculosis among migrants. Int J Infect Dis. 2017;56:85-9.  https://doi.org/10.1016/j.ijid.2016.11.002  PMID: 27836793 
  38. Dara M, Solovic I, Sotgiu G, D’Ambrosio L, Centis R, Tran R, et al. Tuberculosis care among refugees arriving in Europe: a ERS/WHO Europe Region survey of current practices. Eur Respir J. 2016;48(3):808-17.  https://doi.org/10.1183/13993003.00840-2016  PMID: 27492827 
  39. Liu Y, Posey DL, Cetron MS, Painter JA. Effect of a culture-based screening algorithm on tuberculosis incidence in immigrants and refugees bound for the United States: a population-based cross-sectional study. Ann Intern Med. 2015;162(6):420-8.  https://doi.org/10.7326/M14-2082  PMID: 25775314 
  40. World Health Organisation (WHO). Systematic screening for active tuberculosis: principles ad recommendations. Geneva: WHO; 2013. Available from: http://www.who.int/tb/tbscreening/en/
  41. Slump E, Erkens C, van Hunen R, Schimmel H, van Soolingen D, de Vries G. Tuberculose in Nederland 2015: Surveillancerapport inclusief rapportage monitoring van interventies. [Tuberculosis in the Netherlands 2015: Surveillance report including reporting monitoring of interventions]. Bilthoven: National Institute for Public Health and the Environment (RIVM) 2016. Dutch. Available from: https://www.rivm.nl/dsresource?objectid=378ba7b3-c3ba-4707-8f90-f175a9d18d98&type=pdf&disposition=inline
  42. Public Health England (PHE). Tuberculosis in England 2016 report (presenting data to end of 2015). London: PHE; 2016. Available from: https://www.tbalert.org/wp-content/uploads/2016/09/PHE_TB_Annual_Report_2016.pdf
  43. Forbes B, Banaiee N, Beavis K, Brown-Elliott B, Della Latta P, Elliott B, et al. Laboratory detection and identification of Mycobacteria; approved guideline. M48-A. Wayne: Clinical Laboratory Standards Institute (CLSI); 2008. ISSN 0273-3099. Available from: https://clsi.org/media/1447/m48a_sample.pdf
  44. Rechel B, Mladovsky P, Ingleby D, Mackenbach JP, McKee M. Migration and health in an increasingly diverse Europe. Lancet. 2013;381(9873):1235-45.  https://doi.org/10.1016/S0140-6736(12)62086-8  PMID: 23541058 
  45. Zenner D, Hafezi H, Potter J, Capone S, Matteelli A. Effectiveness and cost-effectiveness of screening migrants for active tuberculosis and latent tuberculous infection. Int J Tuberc Lung Dis. 2017;21(9):965-76.  https://doi.org/10.5588/ijtld.16.0935  PMID: 28826445 
The effectiveness and cost-effectiveness of screening for active tuberculosis among migrants in the EU/EEA: a systematic review
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Christina+Greenaway&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Greenaway Christina</a>, <a href="/search?value1=Manish+Pareek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pareek Manish</a>, <a href="/search?value1=Claire-Nour+Abou+Chakra&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Abou Chakra Claire-Nour</a>, <a href="/search?value1=Moneeza+Walji&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Walji Moneeza</a>, <a href="/search?value1=Iuliia+Makarenko&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Makarenko Iuliia</a>, <a href="/search?value1=Balqis+Alabdulkarim&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Alabdulkarim Balqis</a>, <a href="/search?value1=Catherine+Hogan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hogan Catherine</a>, <a href="/search?value1=Ted+McConnell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McConnell Ted</a>, <a href="/search?value1=Brittany+Scarfo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Scarfo Brittany</a>, <a href="/search?value1=Robin+Christensen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Christensen Robin</a>, <a href="/search?value1=Anh+Tran&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tran Anh</a>, <a href="/search?value1=Nick+Rowbotham&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rowbotham Nick</a>, <a href="/search?value1=Teymur+Noori&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Noori Teymur</a>, <a href="/search?value1=Marieke+J+van+der+Werf&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van der Werf Marieke J</a>, <a href="/search?value1=Kevin+Pottie&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pottie Kevin</a>, <a href="/search?value1=Alberto+Matteelli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Matteelli Alberto</a>, <a href="/search?value1=Dominik+Zenner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zenner Dominik</a>, <a href="/search?value1=Rachael+L+Morton&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Morton Rachael L</a></span>. The effectiveness and cost-effectiveness of screening for active tuberculosis among migrants in the EU/EEA: a systematic review. <a href="/content/ecdc">Euro Surveill.</a> 2018;23(14):pii=17-00542. <a href="https://doi.org/10.2807/1560-7917.ES.2018.23.14.17-00542" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2018.23.14.17-00542</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 31 Jul 2017;&nbsp;&nbsp; <span class="generated">Accepted</span>: 16 Mar 2018 </span> </p>
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    • Supplement 2: Country Specific EU/EEA TB Incidence Rates

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    • Search Strategy #1: Effectiveness and cost-effectiveness search

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