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Prevalence of and risk factors for active tuberculosis in migrants screened before entry to the UK: a population-based cross-sectional study.

Aldridge, RW; Zenner, D; White, PJ; Muzyamba, MC; Loutet, M; Dhavan, P; Mosca, D; ... Abubakar, I; + view all (2016) Prevalence of and risk factors for active tuberculosis in migrants screened before entry to the UK: a population-based cross-sectional study. The Lancet Infectious Diseases , 16 (8) pp. 962-970. 10.1016/S1473-3099(16)00072-4. Green open access

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Abstract

BACKGROUND: An increasing number of countries with low incidence of tuberculosis have pre-entry screening programmes for migrants. We present the first estimates of the prevalence of and risk factors for tuberculosis in migrants from 15 high-incidence countries screened before entry to the UK. METHODS: We did a population-based cross-sectional study of applicants for long-term visas who were screened for tuberculosis before entry to the UK in a pilot programme between Oct 1, 2005, and Dec 31, 2013. The primary outcome was prevalence of bacteriologically confirmed tuberculosis. We used Poisson regression to estimate crude prevalence and created a multivariable logistic regression model to identify risk factors for the primary outcome. FINDINGS: 476 455 visa applicants were screened, and the crude prevalence of bacteriologically confirmed tuberculosis was 92 (95% CI 84-101) per 100 000 individuals. After adjustment for age and sex, factors that were strongly associated with an increased risk of bacteriologically confirmed disease at pre-entry screening were self-report of close or household contact with an individual with tuberculosis (odds ratio 11·6, 95% CI 7·0-19·3; p<0·0001) and being an applicant for settlement and dependant visas (1·3, 1·0-1·6; p=0·0203). INTERPRETATION: Migrants reporting contact with an individual with tuberculosis had the highest risk of tuberculosis at pre-entry screening. To tackle this disease burden in migrants, a comprehensive and collaborative approach is needed between countries with pre-entry screening programmes, health services in the countries of origin and migration, national tuberculosis control programmes, and international public health bodies. FUNDING: Wellcome Trust, Medical Research Council, and UK National Institute for Health Research.

Type: Article
Title: Prevalence of and risk factors for active tuberculosis in migrants screened before entry to the UK: a population-based cross-sectional study.
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/S1473-3099(16)00072-4
Publisher version: http://dx.doi.org/10.1016/S1473-3099(16)00072-4
Language: English
Additional information: © Aldridge et al. Open Access article distributed under the terms of CC BY. For further information, see http://creativecommons.org/licenses/by/3.0/.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/1478404
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