Tackling TB in migrants arriving at Europe's southern border. (December 2021)

• Record Type: Journal Article
• Authors: Goscé, Lara; Girardi, Enrico; Allel, Kasim; Cirillo, Daniela Maria; Barcellini, Lucia; Stancanelli, Giovanna; Matteelli, Alberto; Hagphrast-Bidgoli, Hassan; Abubakar, Ibrahim
• Is Part Of: International journal of infectious diseases. Volume 113(2021)Supplement 1
• Page Start: S28
• Page End: S32
• Publication Date: 2021-12
• Subjects: TB -- Tuberculosis -- Migrants -- Cost-effectiveness analysis; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.02.103
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Over a quarter of TB cases in the European Union can be found in the foreign-born population. Evidence-based interventions have a major role in reducing the spread of tuberculosis among migrants. We utilised data from the E-DETECT TB Italy project to assess the cost-effectiveness of early detection of TB in refugees landing in Sicilian ports. Early case detection is a cost-effective intervention in Italy given the low cost per true-positive case compared to other health interventions. The cost per case detected is below the median annual costs of TB per person at Italian hospitals. Abstract: Over a quarter of the individuals diagnosed with tuberculosis [TB] in the European Union region are born outside of the area and the proportion has been increasing steadily. Italy is a low TB incidence country with over 50% of TB cases in the foreign-born population primarily due to the high numbers of migrants entering the country via land or sea. As a case study to evaluate the value of screening in newly arrived migrants, the EDETECT-TB project in Italy implemented and evaluated active TB screening in the migrant population at first reception centres to ensure early diagnosis to avoid further spread. Based on a cost-effectiveness analysis from a program provider perspective, a decision tree model allowed the assessment of the value for money of case finding by estimating the cost per case of active TB detected compared with the status quo of no screening. The analysis confirmed that early case detection is a cost-effective intervention in areas with migrants arriving from high TB risk settings. Targeted post-arrival early screening of high TB risk vulnerable new entrants to Italy has a potential role in reducing the spread of TB among migrants.