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.
Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the health of refugees and asylum seekers but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the health of refugees and asylum seekers on the basis of this summary alone. The text can be shared and re-used without charge, citing Evidence Aid as the source and noting the date on which you took the text.
We’ve already reached tens of thousands of people with plain language summaries of systematic reviews. If you’d like to help us to continue our work, please consider a donation.
Donate with PayPal
You can also donate through the Charities Aid Foundation (CAF) here. If you are based in the USA and want to make a tax-deductable donation, please donate to Evidence Aid via the British Schools and Universities Foundation.