dc.contributor.author | Greenaway, C | en_US |
dc.contributor.author | Pareek, M | en_US |
dc.contributor.author | Abou Chakra, C-N | en_US |
dc.contributor.author | Walji, M | en_US |
dc.contributor.author | Makarenko, I | en_US |
dc.contributor.author | Alabdulkarim, B | en_US |
dc.contributor.author | Hogan, C | en_US |
dc.contributor.author | McConnell, T | en_US |
dc.contributor.author | Scarfo, B | en_US |
dc.contributor.author | Christensen, R | en_US |
dc.contributor.author | Tran, A | en_US |
dc.contributor.author | Rowbotham, N | en_US |
dc.contributor.author | van der Werf, MJ | en_US |
dc.contributor.author | Noori, T | en_US |
dc.contributor.author | Pottie, K | en_US |
dc.contributor.author | Matteelli, A | en_US |
dc.contributor.author | Zenner, D | en_US |
dc.contributor.author | Morton, RL | en_US |
dc.date.accessioned | 2020-09-29T15:36:50Z | |
dc.date.issued | 2018-04 | en_US |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/67291 | |
dc.description.abstract | BackgroundMigrants account for a large and growing proportion of tuberculosis (TB) cases in low-incidence countries in the European Union/European Economic Area (EU/EEA) which are primarily due to reactivation of latent TB infection (LTBI). Addressing LTBI among migrants will be critical to achieve TB elimination. Methods: We conducted a systematic review to determine effectiveness (performance of diagnostic tests, efficacy of treatment, uptake and completion of screening and treatment) and a second systematic review on cost-effectiveness of LTBI screening programmes for migrants living in the EU/EEA. Results: We identified seven systematic reviews and 16 individual studies that addressed our aims. Tuberculin skin tests and interferon gamma release assays had high sensitivity (79%) but when positive, both tests poorly predicted the development of active TB (incidence rate ratio: 2.07 and 2.40, respectively). Different LTBI treatment regimens had low to moderate efficacy but were equivalent in preventing active TB. Rifampicin-based regimens may be preferred because of lower hepatotoxicity (risk ratio = 0.15) and higher completion rates (82% vs 69%) compared with isoniazid. Only 14.3% of migrants eligible for screening completed treatment because of losses along all steps of the LTBI care cascade. Limited economic analyses suggest that the most cost-effective approach may be targeting young migrants from high TB incidence countries. Discussion: The effectiveness of LTBI programmes is limited by the large pool of migrants with LTBI, poorly predictive tests, long treatments and a weak care cascade. Targeted LTBI programmes that ensure high screening uptake and treatment completion will have greatest individual and public health benefit. | en_US |
dc.language | eng | en_US |
dc.relation.ispartof | Euro Surveill | en_US |
dc.subject | EU/EEA | en_US |
dc.subject | latent TB | en_US |
dc.subject | migrant | en_US |
dc.subject | screening | en_US |
dc.subject | tuberculosis | en_US |
dc.subject | Antitubercular Agents | en_US |
dc.subject | Cost-Benefit Analysis | en_US |
dc.subject | Emigrants and Immigrants | en_US |
dc.subject | Health Care Costs | en_US |
dc.subject | Humans | en_US |
dc.subject | Interferon-gamma Release Tests | en_US |
dc.subject | Latent Tuberculosis | en_US |
dc.subject | Mass Screening | en_US |
dc.subject | Transients and Migrants | en_US |
dc.subject | Tuberculin Test | en_US |
dc.subject | Tuberculosis | en_US |
dc.title | The effectiveness and cost-effectiveness of screening for latent tuberculosis among migrants in the EU/EEA: a systematic review. | en_US |
dc.type | Article | |
dc.identifier.doi | 10.2807/1560-7917.ES.2018.23.14.17-00543 | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/29637889 | en_US |
pubs.issue | 14 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published | en_US |
pubs.volume | 23 | en_US |