Dataset Information

Effects of migration on tuberculosis epidemiological indicators in low and medium tuberculosis incidence countries: A systematic review.

ABSTRACT:

Background

Tuberculosis (TB) remains one of the top ten causes of death each year globally. While the risk of migrant TB is linked to the TB incidence in their country of origin, the migration process can increase the TB risk.

Objective

We aimed to synthesis the evidence on key differences in the epidemiological profile of TB between migrants from high TB incidence birth countries and non-migrants resident in low to medium incidence TB countries.

Methods

We conducted a systematic review where the population was all active TB cases in countries with low to medium TB incidence (<40/100,000 population), the exposure was migration to a low or medium TB incidence country and the comparator was non-migrant TB cases in low or medium incidence countries. Overall proportions were compared between migrants and non-migrants, using Fisher's exact test. Meta-analysis of proportions was carried out for the primary outcome (active TB) while meta-analyses of odds ratios (ORs) were performed using a random effects model for secondary outcomes; sputum-smear positivity, any first line drug resistance, multi-drug resistance (MDR), clustered cases, HIV coinfections and successful treatment. Heterogeneity was evaluated and sources were investigated using subgroup and sensitivity analysis.

Results

Significant differences were found in the overall proportions of high TB incidence migrants and non-migrants for MDR cases, clustered cases, HIV coinfections and successful treatment, as well as a significant difference in the OR among MDR cases (3.91).

Conclusion

This review has demonstrated significant differences in key epidemiological indicators between high TB incidence migrants and non-migrants, indicating policy implications.

SUBMITTER: Jackson S

PROVIDER: S-EPMC7930366 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Publications

Effects of migration on tuberculosis epidemiological indicators in low and medium tuberculosis incidence countries: A systematic review.

Jackson Sarah S Kabir Zubair Z Comiskey Catherine C

Journal of clinical tuberculosis and other mycobacterial diseases 20210222

<h4>Background</h4>Tuberculosis (TB) remains one of the top ten causes of death each year globally. While the risk of migrant TB is linked to the TB incidence in their country of origin, the migration process can increase the TB risk.<h4>Objective</h4>We aimed to synthesis the evidence on key differences in the epidemiological profile of TB between migrants from high TB incidence birth countries and non-migrants resident in low to medium incidence TB countries.<h4>Methods</h4>We conducted a syst ...[more]

PMID: 33681478

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Project description:BackgroundPatient support during tuberculosis treatment is expected to be more often available and more customized in low tuberculosis incidence, high-resource settings than in lower-resource settings. The aim of this systematic review is to provide an overview of tuberculosis patient support interventions implemented in low-incidence countries and an evaluation of their effects on treatment-related outcomes as well as their acceptability by patients and providers.MethodsPubMed, Social Science Citation Index and Cumulative Index to Nursing and Allied Health and Literature were searched for the period 01.2006-05.2016 on publications describing tuberculosis patient support interventions in low-incidence countries (<20 patients per 100,000 population).ResultsThrough our search strategy, 1875 unique publications were identified. Forty publications were included: 17 evaluated patient support quantitatively, 9 qualitatively and 14 only described the patient support. Nineteen publications assessed treatment supervision options only, 21 assessed (combinations of) treatment supervision, socio-economic, psycho-emotional, health-educational and other support. Of eight studies quantitatively evaluating the effects of support with a control group, four showed positive effects: two out of three that used combinations of patient support and two out of five that compared treatment supervision options. Heterogeneity of interventions precluded pooling of results. Qualitative and descriptive studies showed that patients appreciated individualized support including treatment supervision, psycho-emotional and socio-economic support; and digital health interventions.ConclusionOur review shows that a variety of patient support interventions is implemented in low-incidence countries. Although only a few interventions were evaluated quantitatively, we identified potential best practices. The scarcity of evidence on effectiveness, however, indicates the need for further research to evaluate potential best practices.

Project description:ObjectiveTo determine which service models and organisational structures are effective and cost-effective for delivering tuberculosis (TB) services to hard-to-reach populations.DesignEmbase and MEDLINE (1990-2017) were searched in order to update and extend the 2011 systematic review commissioned by National Institute for Health and Care Excellence (NICE), discussing interventions targeting service models and organisational structures for the identification and management of TB in hard-to-reach populations. The NICE and Cochrane Collaboration standards were followed.SettingEuropean Union, European Economic Area, European Union candidate countries and Organisation for Economic Co-operation and Development countries.ParticipantsHard-to-reach populations, including migrants, homeless people, drug users, prisoners, sex workers, people living with HIV and children within vulnerable and hard-to-reach populations.Primary and secondary outcome measuresEffectiveness and cost-effectiveness of the interventions.ResultsFrom the 19?720 citations found, five new studies were identified, in addition to the six discussed in the NICE review. Community health workers from the same migrant community, street teams and peers improved TB screening uptake by providing health education, promoting TB screening and organising contact tracing. Mobile TB clinics, specialised TB clinics and improved cooperation between healthcare services can be effective at identifying and treating active TB cases and are likely to be cost-effective. No difference in treatment outcome was detected when directly observed therapy was delivered at a health clinic or at a convenient location in the community.ConclusionsAlthough evidence is limited due to the lack of high-quality studies, interventions using peers and community health workers, mobile TB services, specialised TB clinics and improved cooperation between health services can be effective to control TB in hard-to-reach populations. Future studies should evaluate the (cost-)effectiveness of interventions on TB identification and management in hard-to-reach populations and countries should be urged to publish the outcomes of their TB control systems.Prospero registration numberCRD42015017865.

Dataset Information

Effects of migration on tuberculosis epidemiological indicators in low and medium tuberculosis incidence countries: A systematic review.

Background

Objective

Methods

Results

Conclusion

Publications

Effects of migration on tuberculosis epidemiological indicators in low and medium tuberculosis incidence countries: A systematic review.

Similar Datasets

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