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

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.

journal_name

Public Health

journal_title

Public health

authors

Garner-Purkis A,Hine P,Gamage A,Perera S,Gulliford MC

doi

10.1016/j.puhe.2018.12.016

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

142-147

eissn

0033-3506

issn

1476-5616

pii

S0033-3506(18)30408-6

journal_volume

168

pub_type

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