Yield of tuberculosis screening in asylum-seekers by country of origin: analysis of screening data in a German federal state (2002–2015)

Extract

Upon-entry screening for tuberculosis (TB) in immigrants plays a major role in national TB programmes of many low TB incidence countries [1]. The majority of European countries conduct routine screening for active TB in refugees and asylum-seekers using chest radiography alone or combined with other diagnostics [2]. Few countries, however, perform targeted screening among the heterogeneous group of asylum-seekers and refugees by using specific selection criteria [3]. Country of origin may serve as a selection criterion [4] to target and prioritise specific sub-groups and avoid “indiscriminate mass screening” [5]. Targeted screening would support front-line health workers to cope with the challenge of performing screening for TB in times of high immigration [6], e.g. in Germany when about 1 million new asylum-seekers were registered in 2015. Despite being desirable, so far a lack of empirical evidence precludes the (objective) determination of a suitable target group in asylum-seekers and refugees: only a few studies have reported the yield of screening for TB by country of origin [7].