Active and latent TB screening in recently arrived persons from Afghanistan: feasibility and lessons learned

Abstract

We describe an active and latent tuberculosis (TB) screening programme undertaken in Manchester, UK in response to the arrival of a cohort of refugees from Afghanistan. In total, 217 adults and 347 children were offered screening, which involved a symptom questionnaire, Mantoux test or interferon gamma release assay, blood-borne virus screening and a chest X-ray in participants over the age of 11. We found a latent TB infection (LTBI) rate of 15% in adults and 1.5% in children, which is lower than global LTBI estimates. One case of active TB was detected. Screening was undertaken in the hotels where participants were temporarily housed, leading to high participant engagement levels. Attendance rates were almost doubled compared with a previous hospital-based screening programme. Hotel-based screening for TB presented several challenges, including transfer of information and results to secondary care. Understanding these challenges and learning from the programme has helped us refine our screening protocol to optimise migrant TB screening in Manchester in the future.

Outcomes from a national screening program for Ukrainian refugees at risk of drug resistant tuberculosis in Wales

“…Recent UK screening of refugees from Afghanistan found LTBI rates of 15% among adults. 10 The major limitations of this study relate to the lack of precise data on arrivals. TB teams received notifications on 44% and screened 36% of all arrivals, highlighting significant missing data.…”