Evidence gaps and/or future research needs to inform optimal screening practices for tuberculosis (TB) in migrants
| Category | Evidence gap/research question |
| Pre-migration screening for TB disease | Can computer-aided analysis of digital chest radiographs improve diagnostic accuracy (reduce false-positive and false-negative reports)? |
| Does the use of Xpert MTB/RIF instead of sputum smear in migrants with abnormal chest radiography improve diagnostic accuracy? | |
| Does the routine use of Xpert MTB/RIF Ultra increase active case finding and diagnostic yield? | |
| Screening for LTBI | Which migrants (e.g. age, immune status and comorbidities) stand to benefit most from LTBI screening and treatment? |
| Is LTBI screening and treatment of specific migrant groups (e.g. TB incidence in country of origin) cost-effective? | |
| Post-migration follow-up | Are post-migration follow-up programmes using serial chest radiographs for early case detection (cost-)effective? |
| Should all migrants with abnormal chest radiography suggestive of previous TB disease, but no current evidence of active TB disease, be offered LTBI treatment (or full TB treatment)? | |
| Asylum seekers and refugees | How can TB and LTBI screening be tailored to the risk profile of refugee and asylum seekers to optimise the screening yield/programme effectiveness? |
| How can TB care be best integrated with other healthcare services for asylum seekers and refugees? | |
| How can the risk of perceived or real victimisation resulting from selective TB screening policies be minimised? | |
| Short-term visitors and those with long-duration multiple-entry visas | Should short-term visitors and people on multiple-entry visas coming from countries with a high incidence of TB to low-incidence countries be screened for TB? If so, how should an optimal screening algorithm look (e.g. including risk stratification)? |
LTBI: latent TB infection.