| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1 Divisions of Clinical Epidemiology and Internal Medicine, Montreal General Hospital, and 2 Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, QC, Canada
CORRESPONDENCE: D. Menzies, Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, Montreal, QC, H2X 2P4, Canada. Fax: 1 5148432083. E-mail: dick.menzies@mcgill.ca
Keywords: Cost-effectiveness, migration, screening, tuberculosis control, tuberculosis diagnosis, tuberculosis prevention
Received: June 18, 2004
Accepted August 25, 2004
ABSTRACT
Today, in Western Europe, Canada and the USA, more than half of all new active tuberculosis (TB) cases occur among foreign-born migrants. This article examines the impact of migration from high TB-incidence to low TB-incidence countries, and compares the cost-effectiveness of different TB control strategies.
A Medline search was conducted to identify relevant English language publications prior to December 2003. Additional articles were identified from the reference lists from these publications.
Despite the high proportion of active cases in low-incidence countries attributable to foreign-born residents, the public health impact is relatively low. Current chest radiograph screening programmes have little impact and are not cost-effective. Screening with sputum culture would improve cost-effectiveness marginally. Treatment of latent infection detected through screening with tuberculin skin testing or chest radiographs may require coercive measures to maximise impact and cost-effectiveness. In contrast, contact tracing, particularly within ethnic communities, appears to be more cost-efficient and less intrusive.
In low-incidence countries, screening of migrants at entry has little overall impact and is not a very cost-effective tuberculosis control strategy. More effective alternatives include contact tracing delivered through primary care and increased investment in global tuberculosis control.
This article has been cited by other articles:
|
|
 |
|
  G. H. Bothamley, L. Ditiu, G. B. Migliori, C. Lange, and TBNET contributors Active case finding of tuberculosis in Europe: a Tuberculosis Network European Trials Group (TBNET) survey Eur. Respir. J., October 1, 2008; 32(4): 1023 - 1030. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. P. Cain, S. R. Benoit, C. A. Winston, and W. R. Mac Kenzie Tuberculosis Among Foreign-Born Persons in the United States JAMA, July 23, 2008; 300(4): 405 - 412. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Erkens, E. Slump, M. Kamphorst, S. Keizer, P. J. H. J. van Gerven, R. Bwire, M. Berkel, M. W. Borgdorff, and S. Verver Coverage and yield of entry and follow-up screening for tuberculosis among new immigrants Eur. Respir. J., July 1, 2008; 32(1): 153 - 161. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Diel, A. Nienhaus, and R. Loddenkemper Cost-effectiveness of Interferon-{gamma} Release Assay Screening for Latent Tuberculosis Infection Treatment in Germany Chest, May 1, 2007; 131(5): 1424 - 1434. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. P. Cain, C. A. Haley, L. R. Armstrong, K. N. Garman, C. D. Wells, M. F. Iademarco, K. G. Castro, and K. F. Laserson Tuberculosis among Foreign-born Persons in the United States: Achieving Tuberculosis Elimination Am. J. Respir. Crit. Care Med., January 1, 2007; 175(1): 75 - 79. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. D. Schoch, P. Rieder, C. Tueller, E. Altpeter, J.-P. Zellweger, H. L. Rieder, M. Krause, and R. Thurnheer Diagnostic Yield of Sputum, Induced Sputum, and Bronchoscopy after Radiologic Tuberculosis Screening Am. J. Respir. Crit. Care Med., January 1, 2007; 175(1): 80 - 86. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Brewin, A. Jones, M. Kelly, M. McDonald, E. Beasley, P. Sturdy, G. Bothamley, and C. Griffiths Is screening for tuberculosis acceptable to immigrants? A qualitative study J. Public Health Med., September 1, 2006; 28(3): 253 - 260. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Poster presentations Thorax, December 1, 2005; 60(suppl_2): ii53 - ii120. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
