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Tuberculosis screening for prospective migrants to high-income countries: systematic review of policies

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Garner-Purkis, Aphra, Hine, Paul, Gamage, Anuji Upekshika, Perera, Suraj N and Gulliford, Martin C (2019) 'Tuberculosis screening for prospective migrants to high-income countries: systematic review of policies'. Public Health, Vol 168, pp. 142-147.

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Abstract

Objective
To compare predeparture tuberculosis (TB) screening policies, including screening criteria and screening tests, and visa requirements for prospective migrants to high-income countries that have low to intermediate TB incidence and high immigration.
Study design
Systematic review of policy documents.
Methods
We systematically identified high-income, high net-migration countries with an estimated TB incidence of <30 per 100,000. After initial selection, this yielded 15 countries which potentially had TB screening policies. We performed a systematic search of governmental and official visa services’ websites for these countries to identify visa information and policy documents for prospective migrants. Results were summarized, tabulated, and compared.
Results
Programs to screen for active TB were identified in all 15 countries, but screening criteria and screening tests varied substantially between countries. Prospective migrants’ country of origin represented an initial assessment criterion which generally focused on elevated TB incidence based on World Health Organization data but also focused on the countries of origin that sent the most migrants, and this varied between destination countries. Specific categories of migrants represented a second assessment criterion that focused on duration of stay and reasons for migration; the focus of which showed variation between the destination countries. Specific screening tests including medical examination and chest X-rays were used as the final stage of assessment, and there were differences between which tests were used between the destination countries.
Conclusions
Current approaches to migrant TB screening are inconsistent in their approach and implementation. While this variation might reflect adaptation to local public health situations, it could also indicate uncertainty concerning optimal strategies. Comparative research studies are needed to define the most effective and efficient methods for TB screening of migrants.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 300 General. Refugees
WA Public Health > WA 55 Registration of notifiable diseases
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1016/j.puhe.2018.12.016
Depositing User: Stacy Murtagh
Date Deposited: 26 Feb 2019 09:51
Last Modified: 26 Feb 2019 09:51
URI: http://archive.lstmed.ac.uk/id/eprint/10223

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