Screening migrants for infectious diseases in Europe
Citation: Seedat F, Hargreaves S, Nellums LB, et al. How effective are approaches to migrant screening for infectious diseases in Europe? A systematic review. Lancet Infectious Diseases. 2018;18(9):e259-71.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: Imperial NIHR Biomedical Research Centre and Imperial College Healthcare Charity, and the Wellcome Trust and European Society for Clinical Microbiology and Infectious Diseases.
What is this? Information from studies of the screening of migrants for infectious disease might help policy makers responding to the arrival of migrants.
In this systematic review, the authors searched for studies of screening for infectious diseases in migrant populations originating from high prevalence countries entering or residing in Europe. They did not restrict their searches by language of publication and searched for articles published between 1989 and 2017. They included 47 studies, which covered screening programmes for tuberculosis, HIV, Chagas disease, toxoplasmosis or multiple diseases.
What was found: Screening for infectious diseases in most European countries is focused on refugees and asylum seekers and single diseases; mainly tuberculosis.
39.3% of the migrant population in Europe had been screened for an infectious disease.
Any infection was detected in 3.74% of migrants.
Uptake of screening by migrants was high (79.5%), especially in primary health care (96.8%), although screening was not completed in 24.6% of cases.
The included studies suggest moderate to high cost-effectiveness of screening programmes, depending on the migrant group and disease targeted. Tuberculosis and hepatitis B or C screening programmes were most cost-effective when targeted at migrants from high-incidence countries.
Implications: The authors of the review stated that the approach to screening in Europe is too restricted in scope, because it focuses on single diseases and a subset of forced migrants. They concluded that new strategies should be developed and implemented to deliver screening and increase completion of necessary treatment for multiple key infections in a wider range of at-risk migrants.
Other considerations: The authors of the review discussed their findings in the context of place of residence.
This summary was prepared by Catherine Haynes, edited by Sydney Johnson and finalized by Mike Clarke.
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