1887
  1. Home
  2. Eurosurveillance
  3. Volume 27, Issue 12, 24/Mar/2022
  4. Article
Research Open Access
Like 0
Download

Abstract

Background

Migrants in low tuberculosis (TB) incidence countries in the European Union (EU)/European Economic Area (EEA) are an at-risk group for latent tuberculosis infection (LTBI) and are increasingly included in LTBI screening programmes.

Aim

To investigate current approaches and implement LTBI screening in recently arrived migrants in the EU/EEA and Switzerland.

Methods

At least one TB expert working at a national level from the EU/EEA and one TB expert from Switzerland completed an electronic questionnaire. We used descriptive analyses to calculate percentages, and framework analysis to synthesise free-text responses.

Results

Experts from 32 countries were invited to participate (30 countries responded): 15 experts reported an LTBI screening programme targeting migrants in their country; five reported plans to implement one in the near future; and 10 reported having no programme. LTBI screening was predominantly for asylum seekers (n = 12) and refugees (n = 11). Twelve countries use ‘country of origin’ as the main eligibility criteria. The countries took similar approaches to diagnosis and treatment but different approaches to follow-up. Six experts reported that drop-out rates in migrants were higher compared with non-migrant groups. Most of the experts (n = 22) called for a renewed focus on expanding efforts to screen for LTBI in migrants arriving in low-incidence countries.

Conclusion

We found a range of approaches to LTBI screening of migrants in the EU/EEA and Switzerland. Findings suggest a renewed focus is needed to expand and strengthen efforts to meaningfully include migrants in these programmes, in order to meet regional and global elimination targets for TB.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2022.27.12.2002070
2022-03-24
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.12.2002070
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/27/12/eurosurv-27-12-2.html?itemId=/content/10.2807/1560-7917.ES.2022.27.12.2002070&mimeType=html&fmt=ahah

References

  1. Sotgiu G, Goletti D, Matteelli A. Global tuberculosis prevention: should we start from the beginning? The European respiratory journal: official journal of the European Society for Clinical Respiratory Physiology. 2019.  https://doi.org/10.1183/13993003.01394-2019  https://doi.org/10.1183/13993003.01394-2019 
  2. Houben RMGJ, Dodd PJ. The Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling. PLoS Med. 2016;13(10):e1002152.  https://doi.org/10.1371/journal.pmed.1002152  PMID: 27780211 
  3. Cohen A, Mathiasen VD, Schön T, Wejse C. The global prevalence of latent tuberculosis: a systematic review and meta-analysis. Eur Respir J. 2019;54(3):1900655.  https://doi.org/10.1183/13993003.00655-2019  PMID: 31221810 
  4. Rustage K, Lobe J, Hayward SE, Kristensen KL, Margineanu I, Stienstra Y, et al. Initiation and completion of treatment for latent tuberculosis infection in migrants globally: a systematic review and meta-analysis. Lancet Infect Dis. 2021;21(12):1701-12.  https://doi.org/10.1016/S1473-3099(21)00052-9  PMID: 34363771 
  5. Öhd JN, Lönnroth K, Abubakar I, Aldridge RW, Erkens C, Jonsson J, et al. Building a European database to gather multi-country evidence on active and latent TB screening for migrants. Int J Infect Dis. 2019;80S:S45-9.  https://doi.org/10.1016/j.ijid.2019.02.041  PMID: 30826482 
  6. World Health Organization (WHO). Latent TB Infection: Updated and consolidated guidelines for programmatic management. Geneva: WHO; 2019. Available from: http://www.who.int/tb/publications/2018/latent-tuberculosis-infection/en/
  7. Pareek M, Watson JP, Ormerod LP, Kon OM, Woltmann G, White PJ, et al. Screening of immigrants in the UK for imported latent tuberculosis: a multicentre cohort study and cost-effectiveness analysis. Lancet Infect Dis. 2011;11(6):435-44.  https://doi.org/10.1016/S1473-3099(11)70069-X  PMID: 21514236 
  8. European Centre for Disease Prevention and Control (ECDC). Public health guidance on screening and vaccination for infectious diseases in newly arrived migrants within the EU/EEA. Stockholm: ECDC; 5 Dec 2018. Available from: https://www.ecdc.europa.eu/en/publications-data/public-health-guidance-screening-and-vaccination-infectious-diseases-newly
  9. Seedat F, Hargreaves S, Nellums LB, Ouyang J, Brown M, Friedland JS. How effective are approaches to migrant screening for infectious diseases in Europe? A systematic review. Lancet Infect Dis. 2018;18(9):e259-71.  https://doi.org/10.1016/S1473-3099(18)30117-8  PMID: 29778396 
  10. Collin SM, de Vries G, Lönnroth K, Migliori GB, Abubakar I, Anderson SR, et al. Tuberculosis in the European Union and European Economic Area: a survey of national tuberculosis programmes. Eur Respir J. 2018;52(6):1801449.  https://doi.org/10.1183/13993003.01449-2018  PMID: 30309977 
  11. Collin SM, Wurie F, Muzyamba MC, de Vries G, Lönnroth K, Migliori GB, et al. Effectiveness of interventions for reducing TB incidence in countries with low TB incidence: a systematic review of reviews. Eur Respir Rev. 2019;28(152):180107.  https://doi.org/10.1183/16000617.0107-2018  PMID: 31142548 
  12. Essadek HO, Mendioroz J, Guiu IC, Barrabeig I, Clotet L, Álvarez P, et al. Community strategies to tackle tuberculosis according to the WHO region of origin of immigrant communities. Public Health Action. 2018;8(3):135-40.  https://doi.org/10.5588/pha.18.0011  PMID: 30271730 
  13. European Centre for Disease Prevention and Control (ECDC). Cost-effectiveness analysis of programmatic screening strategies for latent tuberculosis infection in the EU/EEA. Stockholm: ECDC; 23 Mar 2018. Available from: https://www.ecdc.europa.eu/en/publications-data/cost-effectiveness-analysis-programmatic-screening-strategies-latent-tuberculosis
  14. van der Werf MJ, Rosales-Klintz S, de Vlas SJ. Screening for Latent Tuberculosis (TB) Infection in Low TB Incidence Countries. Clin Infect Dis. 2020;70(4):716-7.  https://doi.org/10.1093/cid/ciz458  PMID: 31161216 
  15. United Nations. (UN) General Assembly. Refworld. Resolution adopted by the General Assembly on 25 September 2015. Transforming our world: the 2030 Agenda for Sustainable Development. New York: UN General Assembly. 21 Oct 2015. Available from: https://www.refworld.org/docid/57b6e3e44.html
  16. Hargreaves S, Nellums LB, Ravensbergen SJ, Friedland JS, Stienstra Y, On Behalf Of The Esgitm Working Group On Vaccination In Migrants. Divergent approaches in the vaccination of recently arrived migrants to Europe: a survey of national experts from 32 countries, 2017. Euro Surveill. 2018;23(41).  https://doi.org/10.2807/1560-7917.ES.2018.23.41.1700772  PMID: 30326996 
  17. European Centre for Disease Prevention and Control (ECDC). Tuberculosis surveillance and monitoring in Europe 2020 –2018 data. Stockholm: ECDC; 24 Mar 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/tuberculosis-surveillance-and-monitoring-europe-2020-2018-data
  18. Kunst H, Burman M, Arnesen TM, Fiebig L, Hergens M-P, 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 
  19. 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 
  20. European Commission. Overall figures of immigrants in European society. Brussels: European Commission; 1 Jan 2020. Available from: https://ec.europa.eu/info/strategy/priorities-2019-2024/promoting-our-european-way-life/statistics-migration-europe_en
  21. European Centre for Disease Prevention and Control (ECDC). Assessing the burden of key infectious diseases affecting migrant populations in the EU/EEA. Stockholm: ECDC; 21 May 2014. Available from: https://www.ecdc.europa.eu/en/publications-data/assessing-burden-key-infectious-diseases-affecting-migrant-populations-eueea#:~:text=The%20report%20'Assessing%20the%20burden,HIV%20and%20tuberculosis%20(TB)
  22. Alsdurf H, Hill PC, Matteelli A, Getahun H, Menzies D. The cascade of care in diagnosis and treatment of latent tuberculosis infection: a systematic review and meta-analysis. Lancet Infect Dis. 2016;16(11):1269-78.  https://doi.org/10.1016/S1473-3099(16)30216-X  PMID: 27522233 
  23. Rosales-Klintz S, Bruchfeld J, Haas W, Heldal E, Houben RMGJ, van Kessel F, et al. Guidance for programmatic management of latent tuberculosis infection in the European Union/European Economic Area. Eur Respir J. 2019;53(1):1802077.  https://doi.org/10.1183/13993003.02077-2018  PMID: 30655449 
Country-specific approaches to latent tuberculosis screening targeting migrants in EU/EEA* countries: A survey of national experts, September 2019 to February 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Ioana+Margineanu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Margineanu Ioana</a>, <a href="/search?value1=Kieran+Rustage&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rustage Kieran</a>, <a href="/search?value1=Teymur+Noori&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Noori Teymur</a>, <a href="/search?value1=Dominik+Zenner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zenner Dominik</a>, <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=Onno+Akkerman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Akkerman Onno</a>, <a href="/search?value1=Sally+Hayward&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hayward Sally</a>, <a href="/search?value1=Jon+S+Friedland&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Friedland Jon S</a>, <a href="/search?value1=Delia+Goletti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Goletti Delia</a>, <a href="/search?value1=Ymkje+Stienstra&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stienstra Ymkje</a>, <a href="/search?value1=Sally+Hargreaves&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hargreaves Sally</a>, <a href="/search?value1=on+behalf+of+the+ESGITM%2FESGMYC+Study+Groups&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the ESGITM/ESGMYC Study Groups</a></span>. Country-specific approaches to latent tuberculosis screening targeting migrants in EU/EEA* countries: A survey of national experts, September 2019 to February 2020. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(12):pii=2002070. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.12.2002070" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.12.2002070</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 10 Dec 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 11 Mar 2021 </span> </p>
/content/10.2807/1560-7917.ES.2022.27.12.2002070
/content/10.2807/1560-7917.ES.2022.27.12.2002070
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error