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
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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