Effectiveness and cost-effectiveness of screening migrants for active tuberculosis and latent tuberculous infection

Dominik Zenner*, H. Hafezi, J. Potter, S. Capone, A. Matteelli

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

34 Citations (Scopus)

Abstract

With the advent of the World Health Organization End TB strategy, there has been renewed interest in screening for active tuberculosis (TB), and particularly latent tuberculous infection (LTBI). In low-incidence countries, a high proportion of TB cases are notified among migrants, which often occurs due to LTBI reactivation.We aimed to review the effectiveness and cost-effectiveness of screening migrants for active TB LTBI to inform and support the TB elimination strategy in low-incidence countries. We carried out a narrative review of English language articles published between 1 January 2000 and 31 June 2016 using the PubMed database. All studies that described the effectiveness or cost-effectiveness of active TB or LTBI screening amongmigrantswere included.We identified 55 studies, and included 40 for the effectiveness of screening, 11 for cost-effectiveness and 4 that reported both. Screening for active TB can be effective and costeffective depending on the setting, target group and screening approach. Pre-entry screening programmes have some impact on the epidemiology of the receiving countries. The effectiveness and cost-effectiveness of LTBI screening as predicted in mathematical models is also highly setting-specific, with best potential results achieved if screening is restricted to high-risk groups and/ or to migrants from high-burden countries.

Original languageEnglish
Pages (from-to)965-976
Number of pages12
JournalInternational Journal of Tuberculosis and Lung Disease
Volume21
Issue number9
DOIs
Publication statusPublished - 1 Sep 2017

Bibliographical note

Funding Information:
DZ and AM also gratefully acknowledge funding received from the European Union’s Health Programme (2014-2020) under the E-DETECT TB project (grant agreement number 709624). Conflicts of interest: none declared.

Funding Information:
The research was partially funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Respiratory Infections at Imperial College London, London, in partnership with Public Health England (PHE), London, UK. The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR, the UK Department of Health or PHE.

Publisher Copyright:
© 2017 The Union.

Keywords

  • Cost-effectiveness
  • Effectiveness
  • LTBI screening
  • Public health impact
  • TB case finding

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