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Published on: April 5, 2017
Evaluation of immigrant tuberculosis screening in industrialized countries
Manish Pareek1, Iacopo Baussano, Ibrahim Abubakar
1Imperial College London, London, UK.
Emerging Infectious Diseases
|August 31, 2012
Summary
Industrialized nations often screen immigrants for tuberculosis (TB) but rarely for latent TB infection (LTBI). Screening policies for LTBI vary widely, necessitating cost-effectiveness research for immigrant health.
Area of Science:
- Public Health
- Infectious Diseases
- Immigration Health
Background:
- Tuberculosis (TB) cases in industrialized nations are increasingly concentrated among immigrants.
- Reactivation of imported latent TB infection (LTBI) is a primary driver of TB incidence in these populations.
Purpose of the Study:
- To examine the mechanisms used by Organisation for Economic Co-operation and Development (OECD) countries to screen immigrants for TB and LTBI.
- To identify variations in screening approaches, targeted populations, and diagnostic methods.
Main Methods:
- An anonymous 18-point questionnaire was distributed to 31 OECD member countries.
- Data on active TB and LTBI screening practices, targeted demographics, and diagnostic tools were collected and analyzed.
Main Results:
- 29 countries responded, with 25 screening for active TB and only 16 screening for LTBI.
- Significant variations were observed in age targeting and the TB incidence thresholds used to define high-risk immigrant groups.
- Tuberculin skin test (TST) was the most common LTBI screening tool, with interferon-γ release assays (IGRAs) used primarily for confirmation.
Conclusions:
- Industrialized countries infrequently screen immigrants for LTBI, and screening policies exhibit wide variation.
- There is an urgent need to establish cost-effective strategies for LTBI screening among immigrant populations to improve public health outcomes.
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