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dc.contributor.authorGreenaway, Cen_US
dc.contributor.authorPareek, Men_US
dc.contributor.authorAbou Chakra, C-Nen_US
dc.contributor.authorWalji, Men_US
dc.contributor.authorMakarenko, Ien_US
dc.contributor.authorAlabdulkarim, Ben_US
dc.contributor.authorHogan, Cen_US
dc.contributor.authorMcConnell, Ten_US
dc.contributor.authorScarfo, Ben_US
dc.contributor.authorChristensen, Ren_US
dc.contributor.authorTran, Aen_US
dc.contributor.authorRowbotham, Nen_US
dc.contributor.authorNoori, Ten_US
dc.contributor.authorvan der Werf, MJen_US
dc.contributor.authorPottie, Ken_US
dc.contributor.authorMatteelli, Aen_US
dc.contributor.authorZenner, Den_US
dc.contributor.authorMorton, RLen_US
dc.description.abstractBACKGROUND: The foreign-born population make up an increasing and large proportion of tuberculosis (TB) cases in European Union/European Economic Area (EU/EEA) low-incidence countries and challenge TB elimination efforts. Methods: We conducted a systematic review to determine effectiveness (yield and performance of chest radiography (CXR) to detect active TB, treatment outcomes and acceptance of screening) and a second systematic review on cost-effectiveness of screening for active TB among migrants living in the EU/EEA. Results: We identified six systematic reviews, one report and three individual studies that addressed our aims. CXR was highly sensitive (98%) but only moderately specific (75%). The yield of detecting active TB with CXR screening among migrants was 350 per 100,000 population overall but ranged widely by host country (110-2,340), migrant type (170-1,192), TB incidence in source country (19-336) and screening setting (220-1,720). The CXR yield was lower (19.6 vs 336/100,000) and the numbers needed to screen were higher (5,076 vs 298) among migrants from source countries with lower TB incidence (≤ 50 compared with ≥ 350/100,000). Cost-effectiveness was highest among migrants originating from high (> 120/100,000) TB incidence countries. The foreign-born had similar or better TB treatment outcomes than those born in the EU/EEA. Acceptance of CXR screening was high (85%) among migrants. Discussion: Screening programmes for active TB are most efficient when targeting migrants from higher TB incidence countries. The limited number of studies identified and the heterogeneous evidence highlight the need for further data to inform screening programmes for migrants in the EU/EEA.en_US
dc.relation.ispartofEuro Surveillen_US
dc.subjectactive tuberculosisen_US
dc.subjectCost-Benefit Analysisen_US
dc.subjectEmigrants and Immigrantsen_US
dc.subjectEuropean Unionen_US
dc.subjectMass Screeningen_US
dc.subjectTransients and Migrantsen_US
dc.titleThe effectiveness and cost-effectiveness of screening for active tuberculosis among migrants in the EU/EEA: a systematic review.en_US
pubs.notesNot knownen_US

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