HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Klinkenberg, E. Articles by Verver, S. PubMed PubMed Citation Articles by Klinkenberg, E. Articles by Verver, S.

Migrant tuberculosis screening in the EU/EEA: yield, coverage and limitations

¹ KNCV Tuberculosis Foundation, The Hague, ² Dept of Infectious Disease, Tropical Medicine and AIDS, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. ³ European Centre for Disease Prevention and Control, Stockholm, Sweden.

CORRESPONDENCE: D. Manissero, Scientific Advice Unit, European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden. E-mail: Davide.Manissero{at}ecdc.europa.eu

Keywords: Coverage, migrant, screening, systematic review, tuberculosis, yield

Received: March 6, 2009
Accepted April 14, 2009

A systematic literature review was performed with the objective of assessing the effectiveness of tuberculosis (TB) screening methods and strategies in migrants in European Union/European Economic Area (including Switzerland) countries.

Extracted data on yield and coverage were used as indicators of effectiveness. Reported yields varied considerably between studies and countries. Considering only the 14 studies representative of national screening programmes, a median yield of TB disease of 0.18% (interquartile range 0.10–0.35%) was reported.

The data did not indicate differences in effectiveness between the three main strategies: 1) screening at port of entry; 2) screening just after arrival in reception/holding centres; and 3) screening in the community following arrival in European Union countries. The variation seen probably reflects variation in risk factors for TB, in particular the composition of the migrants entering the country.

Recommendations include the need for improved data for guiding the optimal frequency and duration of screening; assessment and improvement of cost-effectiveness; access to healthcare for migrants, including illegal migrants; ensuring a continuum of care for those screened; and consideration of screening for latent TB infection with caution. Finally, screening should be a component of a wider approach, rather than a stand-alone intervention.