eprintid: 10046167 rev_number: 24 eprint_status: archive userid: 608 dir: disk0/10/04/61/67 datestamp: 2018-04-06 10:02:59 lastmod: 2021-12-01 23:57:42 status_changed: 2018-04-06 10:05:28 type: article metadata_visibility: show creators_name: Zenner, D title: The effectiveness and cost-effectiveness of screening for active tuberculosis among migrants in the EU/EEA: a systematic review ispublished: pub divisions: UCL divisions: B02 divisions: D01 divisions: G16 note: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ abstract: Background : The foreign-born population make up an increasing and large proportion of tuberculosis (TB) cases in European Union/European Economic Area (EU/EEA) low-incidence countries and challenge TB elimination efforts. Methods: We conducted a systematic review to determine effectiveness (yield and performance of chest radiography (CXR) to detect active TB, treatment outcomes and acceptance of screening) and a second systematic review on cost-effectiveness of screening for active TB among migrants living in the EU/EEA. Results: We identified six systematic reviews, one report and three individual studies that addressed our aims. CXR was highly sensitive (98%) but only moderately specific (75%). The yield of detecting active TB with CXR screening among migrants was 350 per 100,000 population overall but ranged widely by host country (110–2,340), migrant type (170–1,192), TB incidence in source country (19–336) and screening setting (220–1,720). The CXR yield was lower (19.6 vs 336/100,000) and the numbers needed to screen were higher (5,076 vs 298) among migrants from source countries with lower TB incidence (≤ 50 compared with ≥ 350/100,000). Cost-effectiveness was highest among migrants originating from high (> 120/100,000) TB incidence countries. The foreign-born had similar or better TB treatment outcomes than those born in the EU/EEA. Acceptance of CXR screening was high (85%) among migrants. Discussion: Screening programmes for active TB are most efficient when targeting migrants from higher TB incidence countries. The limited number of studies identified and the heterogeneous evidence highlight the need for further data to inform screening programmes for migrants in the EU/EEA. date: 2018-04-05 date_type: published official_url: https://doi.org/10.2807/1560-7917.ES.2018.23.14.17-00542 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green article_type_text: Article verified: verified_manual elements_id: 1547169 doi: 10.2807/1560-7917.ES.2018.23.14.17-00542 lyricists_name: Zenner, Dominik lyricists_id: DZENN29 actors_name: Zenner, Dominik actors_name: Stacey, Thomas actors_id: DZENN29 actors_id: TSSTA20 actors_role: owner actors_role: impersonator full_text_status: public publication: Eurosurveillance volume: 23 number: 14 article_number: pii=17-00542 citation: Zenner, D; (2018) The effectiveness and cost-effectiveness of screening for active tuberculosis among migrants in the EU/EEA: a systematic review. Eurosurveillance , 23 (14) , Article pii=17-00542. 10.2807/1560-7917.ES.2018.23.14.17-00542 <https://doi.org/10.2807/1560-7917.ES.2018.23.14.17-00542>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10046167/1/Zenner%20Eurosurveillance%20_%20The%20effectiveness%20and%20cost-effectiveness%20of%20screening%20for%20active%20tuberculosis%20among%20migrants%20in%20the%20EU_EEA_%20a%20systematic%20review.pdf