HIV and tuberculosis co-infection among migrants in Europe: A systematic review on the prevalence, incidence and mortality

Abstract

BackgroundInternational human migration has been rapidly growing. Migrants coming from low and middle income countries continue to be considerably vulnerable and at higher risk for infectious diseases, namely HIV (Human Immunodeficiency Virus) and tuberculosis (TB). In Europe, the number of patients with HIV-TB co-infection has been increasing and migration could be one of the potential driving forces.ObjectiveThis systematic review aims to improve the understanding on the burden of HIV-TB co-infection among migrants in Europe and to assess whether these populations are particularly vulnerable to this co-infection compared to nationals.DesignMEDLINE®, Web of Science® and Scopus® databases were searched from March to April 2016 using combinations of keywords. Titles and abstracts were screened and studies meeting the inclusion criteria proceeded for full-text revision. These articles were then selected for data extraction on the prevalence, incidence and mortality.ResultsThe majority of HIV-TB prevalence data reported in the analysed studies, including extrapulmonary/disseminated TB forms, was higher among migrant vs. nationals, some of the studies even showing increasing trends over time. Additionally, while HIV-TB incidence rates have decreased among migrants and nationals, migrants are still at a higher risk for this co-infection. Migrants with HIV-TB co-infection were also more prone to unsuccessful treatment outcomes, death and drug resistant TB. However, contradicting results also showed lower mortality compared to nationals.ConclusionsOverall, a disproportionate vulnerability of migrants to acquire the HIV-TB co-infection was observed across studies. Such vulnerability has been associated to low socioeconomic status, poor living conditions and limited access to healthcare. Adequate social support, early detection, appropriate treatment, and adequate access to healthcare are key improvements to tackle HIV-TB co-infection among these populations.

Factors influencing the higher incidence of tuberculosis among migrants and ethnic minorities in the UK

“…A systematic review on the prevalence, incidence and mortality of HIV-TB co-infection in Europe observed a disproportionate vulnerability of migrants to co-infection across studies 134 . Given that only 3.8% of TB cases in England in 2015 involved co-infection with HIV 14 , TB-HIV co-infection cannot be considered a major driver of higher TB incidence among migrants and ethnic minorities in the UK; although this group represents an important target in the prevention of M.tb infection and progression to active disease.…”

Migration und Tuberkulose

“…Extrapulmonale Tuberkulosen bei HIV-Patienten sind häufiger (▶ Abb. 7), ebenso Therapieversagen und eine multiresistente Tuberkulose [27].…”

The role of tuberculosis control institutes in delivering tuberculosis information to domestic migrants in China: A multi-level analysis of a nationwide cross-sectional survey

“…Domestic migrants in China regularly move from rural areas to host cities for work without permanent residency (Hukou) (Huinink et al, 2014). Large studies have shown that these migrants are more vulnerable to TB infection than local people and have become a contributor to TB epidemics (Tavares et al, 2017). Again, reasons for this are reportedly due to a lack of TB awareness when compared with local residents (Pengpid et al, 2016;Nkulu et al, 2010).…”