title: Tuberculosis care among refugees arriving in Europe: a ERS/WHO Europe Region survey of current practices.
abstract: No evidence exists on tuberculosis (TB) and latent TB infection (LTBI) management policies among refugees in European countries.A questionnaire investigating screening and management practices among refugees was sent to 38 national TB programme representatives of low and intermediate TB incidence European countries/territories of the WHO European Region.Out of 36 responding countries, 31 (86.1%) reported screening for active TB, 19 for LTBI, and eight (22.2%) reporting outcomes of LTBI treatment. Screening for TB is based on algorithms including different combinations of symptom-based questionnaires, bacteriology and chest radiography and LTBI screening on different combinations of tuberculin skin test and interferon-γ release assays. In 22 (61.1%) countries, TB and LTBI screening are performed in refugee centres. In 22 (61.1%) countries, TB services are organised in collaboration with the private sector. 27 (75%) countries answered that screening for TB is performed as per national and international guidelines, while 19 (52.7%) gave the same answer with regards to LTBI screening. Infection control measures are inadequate in several of the countries surveyed.There is need for improved coordination of TB screening in Europe to implement the End TB Strategy and achieve TB elimination.
authors: World Health Organization Office at the European Union, Brussels, Belgium These authors contributed equally.
authors: Masoud
authors: M
authors: Dara
authors: National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy, Catholic University Ruzomberok, Ruzomberok, Slovakia These authors contributed equally.
authors: Ivan
authors: I
authors: Solovic
authors: Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari - Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy These authors contributed equally.
authors: Giovanni
authors: G
authors: Sotgiu
authors: WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri IRCCS, Tradate, Italy Public Health Consulting Group, Lugano, Switzerland These authors contributed equally.
authors: Lia
authors: L
authors: D'Ambrosio
authors: WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri IRCCS, Tradate, Italy These authors contributed equally.
authors: Rosella
authors: R
authors: Centis
authors: World Health Organization Office at the European Union, Brussels, Belgium These authors contributed equally.
authors: Richard
authors: R
authors: Tran
authors: Translational Research Unit, Epidemiology Dept, National Institute for Infectious Diseases, Rome, Italy.
authors: Delia
authors: D
authors: Goletti
authors: EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal.
authors: Raquel
authors: R
authors: Duarte
authors: School of Medicine and Surgery, University of Milan-Bicocca, UO Clinica Pneumologica, AO San Gerardo, Monza, Italy.
authors: Stefano
authors: S
authors: Aliberti
authors: Dept of Pediatrics, Salesi Children's Hospital Foundation, Ancona, Italy.
authors: Fernando Maria
authors: FM
authors: de Benedictis
authors: Dept of Respiratory Medicine, Homerton University Hospital NHS Foundation Trust, London, UK.
authors: Graham
authors: G
authors: Bothamley
authors: Dept of Pneumology, Diaconess Hospital Rotenburg/Wümme, Rotenburg/Wümme, Germany.
authors: Tom
authors: T
authors: Schaberg
authors: Institute for Global Health, University College London, London, UK.
authors: Ibrahim
authors: I
authors: Abubakar
authors: European Respiratory Society, Brussels Office, Brussels, Belgium.
authors: Vitor
authors: V
authors: Teixeira
authors: European Respiratory Society, Brussels Office, Brussels, Belgium.
authors: Brian
authors: B
authors: Ward
authors: University Respiratory Medicine Unit, Evgenidio Hospital, Athens, Greece.
authors: Christina
authors: C
authors: Gratziou
authors: WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri IRCCS, Tradate, Italy giovannibattista.migliori@fsm.it.
authors: Giovanni Battista
authors: GB
authors: Migliori
mesh_terms: D000465:Algorithms; D003140:Communicable Disease Control; D005060:Europe; D006801:Humans; D015994:Incidence; D059425:Interferon-gamma Release Tests; D055985:Latent Tuberculosis / Q000175:diagnosis; D008403:Mass Screening; D017410:Practice Guidelines as Topic; D012036:Refugees; D011795:Surveys and Questionnaires; D014171:Transients and Migrants; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D014944:World Health Organization