Multidrug-resistant tuberculosis and migration to Europe
Research output: Contribution to journal › Review › Research › peer-review
Multidrug-resistant tuberculosis (MDR-TB) in low-incidence countries in Europe is more prevalent among migrants than the native population. The impact of the recent increase in migration to EU and EEA countries with a low incidence of TB (<20 cases per 100 000) on MDR-TB epidemiology is unclear. This narrative review synthesizes evidence on MDR-TB and migration identified through an expert panel and database search. A significant proportion of MDR-TB cases in migrants result from reactivation of latent infection. Refugees and asylum seekers may have a heightened risk of MDR-TB infection and worse outcomes. Although concerns have been raised around 'health tourists' migrating for MDR-TB treatment, numbers are probably small and data are lacking. Migrants experience significant barriers to testing and treatment for MDR-TB, exacerbated by increasingly restrictive health systems. Screening for latent MDR-TB is highly problematic because current tests cannot distinguish drug-resistant latent infection, and evidence-based guidance for treatment of latent infection in contacts of MDR patients is lacking. Although there is evidence that transmission of TB from migrants to the general population is low-it predominantly occurs within migrant communities-there is a human rights obligation to improve the diagnosis, treatment and prevention of MDR-TB in migrants. Further research is needed into MDR-TB and migration, the impact of screening on detection or prevention, and the potential consequences of failing to treat and prevent MDR-TB among migrants in Europe. An evidence-base is urgently needed to inform guidelines for effective approaches for MDR-TB management in migrant populations in Europe.
Original language | English |
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Journal | Clinical Microbiology and Infection |
Volume | 23 |
Issue number | 3 |
Pages (from-to) | 141-146 |
Number of pages | 6 |
ISSN | 1198-743X |
DOIs | |
Publication status | Published - Mar 2017 |
- Antitubercular Agents, Diagnostic Tests, Routine, Disease Transmission, Infectious, Emigration and Immigration, Europe, Humans, Infection Control, Medication Adherence, Tuberculosis, Multidrug-Resistant, Journal Article, Review
Research areas
ID: 187016048