Several countries have achieved low tuberculosis incidence while having large populations of migrants from countries with high tuberculosis burdens.1, 2, 3 In many of these countries with low burdens of tuberculosis, a large proportion of disease now occurs in individuals born outside the country.4, 5 Elimination of tuberculosis in countries with low incidence of the disease is expected to require multiple interventions, including, but not limited to, innovation in screening of migrants.
A systematic review6 published in 2014 showed that, in pre-entry screening of migrants before travel to low-incidence countries, the largest number of cases was detected when screening was done in high-incidence countries. One-off pre-entry screening for active tuberculosis in migrants will detect only disease prevalent at the time of screening. Few linked data are available for incident tuberculosis after migration to low-incidence…. continue reading http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31008-X/fulltext?elsca1=etoc