Tuberculosis control in Europe and international migration

Abstract

T Tu ub be er rc cu ul lo os si is s c co on nt tr ro ol l i in n E Eu ur ro op pe e a an nd d i in nt te er rn na at ti io on na al l m mi ig gr ra at ti io on nTuberculosis among the foreign population entering European countries represents an increasing and important proportion of all tuberculosis cases reported in these countries. Adequate surveillance systems allow the identification of population segments at an excess risk of tuberculosis compared to the general population. Among groups of foreigners with a risk considerably exceeding that of the general population, screening for tuberculosis and infection with M. tuberculosis yields a large number of persons in many countries who can benefit from curative and preventive interventions.The Task Force recommends that European countries: 1) have notification systems based on both mandatory laboratory and physician reports of tuberculosis cases, to allow identification of population segments at an excess incidence of tuberculosis compared to the general population; 2) consider screening of high incidence and prevalence groups among the entering foreign population for tuberculosis and infection with M. tuberculosis amenable to curative and preventive intervention; 3) utilize existing governmental and nongovernmental organizations to provide culturally and socially sensitive services to ensure proper follow-up and implementation of interventions; 4) provide comprehensive curative and preventive services to treat tuberculosis; and 5) evaluate efficiency and efficacy of screening procedures on an ongoing basis.

Active screening at entry for tuberculosis among new immigrants: a systematic review and meta-analysis

“…In particular, screening programmes targeting high-risk groups within the framework of coordinated activities of control and management of tuberculosis, such as contact tracing investigations and tailored directly observed treatment programmes, can be successful in reducing the burden among migrants [4,8]. The early identification and management of tuberculosis among immigrants before they are dispersed within the host country is expected to prevent unnecessary transmission between recent immigrants.…”

“…Contact patterns, both within and outside the migrant communities, immigration patterns and tuberculosis control measures are likely to affect the effective contact between infectious and susceptible individuals [3]. Thus, migrants from countries with a high prevalence of tuberculosis may play a role as a source of tuberculosis infection, particularly within migrant communities [4,5]. The dramatic rise in migration to Europe and the potential consequences of this in terms of infectious disease circulation has recently been addressed at the Second Conference on Applied Infectious Disease Epidemiology, supported by the European Centre for Disease Prevention and Control [6].…”

Yield of tuberculosis contact investigation in a low-incidence country

“…Since the 1950s the incidence of TB has fallen dramatically in high-and middle-income countries (1,2), while it has recently emerged as a public health concern in many low-income countries (3). The World Health Organization (WHO) estimated that globally in 2012 there were 8.6 million incident cases of TB, and 1.3 million deaths from the disease (4).…”

Social determinants of tuberculosis in Europe: a prospective ecological study

“…Finally, from a psychosocial perspective, social capital and its dimensions, such as social trust and social participation, have been suggested as important predictors for country-level variation in health [22]. To this explanatory framework we added net migration rates for each country, since, to a certain extent, immigration in Europe originates from countries where TB is endemic [23,24].…”