Is screening for tuberculosis acceptable to immigrants? A qualitative study.
BACKGROUND
Screening of immigrants has been a widespread response to the global resurgence of tuberculosis but has been criticized as discriminatory and stigmatising. Acceptability is an essential but neglected ethical prerequisite of screening programmes, particularly those targeting vulnerable groups such as refugees. No data exist concerning acceptability of tuberculosis screening. We therefore examined the responses of immigrants to screening for tuberculosis in a range of settings.


METHODS
We carried out a qualitative interview study of a maximum diversity sample of 53 immigrants offered screening for tuberculosis in east London. We recruited people screened in three settings: a social service centre for asylum seekers, a hospital clinic for new entrants and primary care. We confirmed validity of our findings at a focus group of asylum seekers.


RESULTS
The opportunity to be screened for tuberculosis was valued highly by recipients. Moreover, many saw being screened as a socially responsible activity. Of the minority raising concerns, few mentioned the possibility of discrimination. Acceptability was high irrespective of setting, with respondents expressing preference for their chosen place of screening.


CONCLUSIONS
Screening for tuberculosis was highly acceptable to recipients in these settings. Screening should be offered in a range of settings.
Brewin
P
P
Department of Respiratory Medicine, Homerton University Hospital, Homerton Row, London E9 6SR, UK.
Jones
A
A
Kelly
M
M
McDonald
M
M
Beasley
E
E
Sturdy
P
P
Bothamley
G
G
Griffiths
C
C
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008131:London; D008297:Male; D008403:Mass Screening / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D014376:Tuberculosis / Q000175:diagnosis*