
Tuberculosis screening in migrants to the EU/EEA and UK
Tuberculosis screening in migrants to the EU/EEA and UK
Niklas Köhler, Anca Vasiliu, Anna Maria Mandalakas, Leonardo Martinez, Christoph Langefor the TBnet
European Respiratory Journal 2023 62: 2301230; DOI: 10.1183/13993003.01230-2023
Extract
With great interest we read the article by Zenner et al. [1] on drivers determining tuberculosis screening yield in four European countries. The authors pooled individual-level data from national tuberculosis screening programmes in Italy, the Netherlands, Sweden and the UK. The dataset includes 1658 tuberculosis cases among 2 107 016 migrants between 2005 and 2018. The authors show that among all types of migrants (students and workers, asylum seekers, individuals on settlement and family visas, and those on working holidays), screening asylum seekers would have the highest yield, followed by screening all other types of migrants from countries that have a tuberculosis incidence of >100 per 100 000 population [1]. Within the group of asylum seekers, the screening yield stagnated above an incidence in country of origin of 100 per 100 000 population, indicating that the adverse circumstances of their journeys or their arrival had a stronger impact on tuberculosis incidence among asylum seekers and refugees than the tuberculosis incidence in their country of origin. The authors advocate to account for tuberculosis-related risk factors as well as to develop regional tuberculosis control recommendations.
Tuberculosis screening polices in EU/EEA countries should be informed by national or regional data for the tuberculosis risk of migrants in their new country of residence, not only by WHO estimates of incidences in the country of origin https://bit.ly/3OybcCe
Footnotes
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Collaborators in the TBnet: Niklas Köhler (Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany; German Center for Infection Research (DZIF), TTU-TB, Borstel, Germany; Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany), Anca Vasiliu (Baylor College of Medicine, Department of Pediatrics, Global and Migrant Health, Global Tuberculosis Program, Houston, TX, USA), Ekkehardt Altpeter (Swiss Federal Office of Public Health, Division of Communicable Diseases, Bern, Switzerland), Tinna Rán Ægisdóttir (The National University Hospital of Iceland, Pharmaceutical Services, Reykjavik, Iceland), Marina Amerali (Tuberculosis Control Office, Dept of Respiratory Infections, Directorate for Epidemiological Surveillance and Intervention, National Public Health Organization (NPHO), Athens, Greece), Wouter Arrazola de Oñate (Belgian Lung and Tuberculosis Association, Brussels, Belgium; Flemish Association of Respiratory Health and TB Control, Leuven, Belgium), Ãgnes Bakos (Koranyi National Institute for Pulmonology, Budapest, Hungary), Stefania D'Amato (Prevention of Communicable Diseases and International Prophylaxis, General Direction of Health Prevention, Ministry of Health of Italy, Rome, Italy), Daniela Maria Cirillo (IRCCS San Raffaele Scientific Institute, Milan, Italy), Reinout van Crevel (Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK), Edita Davidaviciene (Vilnius University Hospital Santaros Klinikos, Department of Tuberculosis State Information System, Vilnius, Lithuania), Irène Demuth (Health Directorate of Luxembourg, Luxembourg), Jose DomÃnguez (Institut d'Investigació Germans Trias i Pujol; Universitat Autònoma de Barcelona; CIBER Enfermedades Respiratorias; INNOVA4TB consortium, Badalona, Barcelona, Spain), Raquel Duarte (ICBAS – Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto; ISPUP – Instituto de Saúde Pública da Universidade do Porto; Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal), Gunar Günther (Department of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department of Medical Sciences, School of Medicine, University of Namibia, Windhoek, Namibia), Jean-Paul Guthmann (Division of Infectious Diseases, Santé publique France, Saint-Maurice, France), Sophia Hatzianastasiou (Tuberculosis Control Office, Dept of Respiratory Infections Directorate for Epidemiological Surveillance and Intervention, National Public Health Organization (NPHO), Athens, Greece), Louise Hedevang Holm (Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark), Zaida Herrador Ortiz (National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain), UrÅ¡ka Hribar (Tuberculosis Register of the Republic of Slovenia, University Clinic Golnik, Golnik, Slovenia), Conny Huberty (Health Directorate of Luxembourg, Luxembourg), Elmira Ibraim (Marius Nasta Institute of Pulmonology, Bucharest, Romania), Sarah Jackson (Infectious Diseases, Health Service Executive – Health Protection Surveillance Centre, Dublin, Ireland), Mogens Jensenius (Department of Infectious Diseases, Oslo University Hospital, Ullevaal, Norway), Kamilla Sigridur Josefsdottir (Centre for Health Security and Communicable Disease Control, Directorate of Health, Iceland), Anders Koch (Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark; Department of Infectious Diseases, Rigshospitalet University Hospital, Copenhagen, Denmark), Maria Korzeniewska-Kosela (Department of Tuberculosis Epidemiology and Surveillance, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland), Liga Kuksa (Riga East University Hospital, TB and Lung Disease Clinic, Riga, Latvia), Heinke Kunst (Blizard Institute, The London School of Medicine and Dentistry, Queen Mary University of London, London, UK), Christian Lienhardt (Unité Unité Mixte Internationale 233 IRD – U1175 INSERM – Université de Montpellier, Institut de Recherche pour le Développement (IRD), Montpellier, France; Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK), Beatrice Mahler (Department Pneumology I, Marius Nasta Institute of Pneumology, Bucharest, Romania; Department Cardio-thoracic, Pneumophtisiology II, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania), Mateja Janković Makek (University of Zagreb, School of Medicine Zagreb, Croatia; University Hospital Centre Zagreb, Department for Lung diseases, Zagreb, Croatia), Paul McKeown (Health Protection Surveillance Centre, Gastrozoonotic and Vectorborne Diseases Division, Dublin, Ireland), Inge Muylle (Division of Pneumology, Onze-Lieve-Vrouw Ziekenhuis (OLV) Aalst, Aalst, Belgium), Johan Normark (Department of Clinical Microbiology, UmeÃ¥ University, Sweden; Wallenberg Centre for Molecular Medicine, UmeÃ¥ University, Sweden), Analita Pace-Asciak (Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Superintendence of Public Health, Ministry for Health of Malta, La Valetta, Malta), Goranka Petrović (Respiratory Diseases and Travel Medicine Department with Vaccination Unit, Infectious Diseases Epidemiology Service Department, Croatian Institute of Public Health, Zagreb, Croatia), Despo Pieridou (Cyprus National Reference Laboratory for Mycobacteria, Microbiology Department, Nicosia General Hospital, Nicosia, Cyprus), Giulia Russo (Emerging Bacterial Pathogens Unit, DITID-IRCCS Ospedale San Raffaele, Milan, Italy), Olena Rzhepishevska (Department of Chemistry, Department of Clinical Microbiology, UmeÃ¥ University, Sweden), Helmut J.F. Salzer (Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine 4/Pneumology, Kepler University Hospital and Faculty of Medicine, Johannes Kepler University, Linz, Austria; Ignaz-Semmelweis-Institute, Interuniversity Institute for Infection Research, Vienna, Austria), Marta Sá Marques (Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal), Daniela Schmid (Unit for Infectious Diseases Diagnostics and Infectious Diseases Epidemiology, Centre for Pathophysiology, Infectious Diseases and Immunology, Medical University of Vienna, Vienna, Austria), Ivan Solovic (National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy; Catholic University Ruzomberok, Ruzomberok, Slovakia), Mariya Sukholytka (First Faculty of Medicine and Faculty Thomayer Hospital Prague, Czech Republic), Petra Svetina (National TB Program and Tuberculosis Registry of Republic of Slovenia, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia), Mariya Tyufekchieva (Health Promotion and Prevention Unit, Directorate Public Health Protection and Health Control, Ministry of Health of Bulgaria, Sofia, Bulgaria), Tuula Vasankari (University of Turku, Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku, Finland; Finnish Lung Health Association (Filha ry), Helsinki, Finland), Piret Viiklepp (Estonian Tuberculosis Register, Dept of Registries, National Institute for Health Development, Tallinn, Estonia), Kersti Villand (Estonian Tuberculosis Register, Dept of Registries, National Institute for Health Development, Tallinn, Estonia), Jiri Wallenfels (National TB Surveillance Unit, University Hospital Bulovka, Prague, Czech Republic), Stefan Wesolowski (National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland), Anna Maria Mandalakas (Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA; Research Center Borstel, Clinical Infectious Diseases, Borstel, Germany), Leonardo Martinez (Boston University, School of Public Health, Department of Epidemiology, Boston, MA, USA), Dominik Zenner (Global Public Health Unit, Wolfson Institute of Population Health Barts, The London School of Medicine and Dentistry, Queen Mary University of London, London, UK), Christoph Lange (Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany; German Center for Infection Research (DZIF), TTU-TB, Borstel, Germany; Respiratory Medicine and International Health, University of Lübeck, Germany; Baylor College of Medicine and Texas ChildreÅ„s Hospital, Houston, TX, USA).
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Conflict of interest: C. Lange is supported by the German Center of Infection Research (DZIF); in addition, C. Lange has provided consultation to Insmed, a company that produced liposomal amikacin as an inhalative suspension for the treatment of NTM-PD, received speaker honoraria from Insmed, Gilead, Janssen and GSK, and is a member of the data safety board for trials of Medicines sans Frontiers, outside the submitted work. The other authors have no potential conflicts of interest to disclose.
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Support statement: This work was supported by Deutsches Zentrum für Infektionsforschung (grant: TTU TB 02.709). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received July 12, 2023.
- Accepted August 7, 2023.
- Copyright ©The authors 2023. For reproduction rights and permissions contact permissions@ersnet.org
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