A multinational Delphi consensus on tuberculosis screening of migrants in Europe

The disproportionate burden of tuberculosis among migrants in the World Health Organization (WHO) European Region underscores the urgent need to address the public health challenges associated with global migration. Recommendations for screening of pulmonary tuberculosis (TB) and TB infection (TBI) are highly variable across European countries, highlighting the need for standardised practices and coordinated efforts to reduce TB risk more effectively. This study aims to produce a harmonised set of recommendations to contribute to elaboration for policy action using the Delphi method. It brings together a multidisciplinary panel of 33 TB experts from academia, healthcare, non-governmental organisations and government agencies across 22 countries to formulate consensus-based recommendations. The panel created 19 consensus statements and 36 recommendations for governments, health systems and other stakeholders. The recommendations span four key domains: 1) policy, 2) health systems and health professionals, 3) screening procedures and priority populations and 4) continued treatment and care. This study recommends a unified, evidence-based approach to TB screening in migrants, with free access to diagnosis and treatment, culturally sensitive care, use of digital tools and coordinated efforts across health systems to ensure effective and equitable TB control in Europe. Thus, the experts emphasised key recommendations that strike a balance between immediate health system interventions, screening procedures and cultural inclusivity to more effectively address TB among migrants. The findings of this study offer actionable policies to address gaps and weaknesses in Europe's response to tuberculosis among migrants, advancing efforts to eliminate TB as a public health threat.

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Publication Details

Journal
ERJ Open Research
Published
2025-10-09
DOI
https://doi.org/10.1183/23120541.00574-2025
Primary Topic
Tuberculosis Research and Epidemiology
Type
article
Field-Weighted Citation Impact
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article

A multinational Delphi consensus on tuberculosis screening of migrants in Europe

Jan‐Willem C. Alffenaar, Marina Pinheiro, Kevin L. Winthrop, Raquel Duarte et al.
ERJ Open Research
Tuberculosis Research and Epidemiology
article

A multinational Delphi consensus on tuberculosis screening of migrants in Europe

Jan‐Willem C. Alffenaar, Marina Pinheiro, Kevin L. Winthrop, Raquel Duarte, Radmila Čurčić, Mario Raviǵlione, Mateja Janković Makek, Tuula Vasankari, Domingo Palmero, Onno W. Akkerman, Ben J. Marais, Nathan Kapata, Diana Moreira, Cristina Vilaplana, Zarir Udwadia, Ineke Spruijt, Zubaida Al-Suwaidi, Gunar Günther, Pierpaolo de Colombani, Christoph Lange, Giovanni Battista Migliori, Delia Goletti, Marc Lipman, A. Pedro Aguiar, Alberto L. García‐Basteiro, Adrián Sánchez Montalvá, Helmut J.F. Salzer, Zorica Nanović, Denise Rossato Silva, Martin Priwitzer, Elmira Ibraim, Cécile Magis-Escurra, Andrei Mariandyshev, Ulisses Brito, Christian Schwarzbach, Irena Arandjelović
article en

Abstract

The disproportionate burden of tuberculosis among migrants in the World Health Organization (WHO) European Region underscores the urgent need to address the public health challenges associated with global migration. Recommendations for screening of pulmonary tuberculosis (TB) and TB infection (TBI) are highly variable across European countries, highlighting the need for standardised practices and coordinated efforts to reduce TB risk more effectively. This study aims to produce a harmonised set of recommendations to contribute to elaboration for policy action using the Delphi method. It brings together a multidisciplinary panel of 33 TB experts from academia, healthcare, non-governmental organisations and government agencies across 22 countries to formulate consensus-based recommendations. The panel created 19 consensus statements and 36 recommendations for governments, health systems and other stakeholders. The recommendations span four key domains: 1) policy, 2) health systems and health professionals, 3) screening procedures and priority populations and 4) continued treatment and care. This study recommends a unified, evidence-based approach to TB screening in migrants, with free access to diagnosis and treatment, culturally sensitive care, use of digital tools and coordinated efforts across health systems to ensure effective and equitable TB control in Europe. Thus, the experts emphasised key recommendations that strike a balance between immediate health system interventions, screening procedures and cultural inclusivity to more effectively address TB among migrants. The findings of this study offer actionable policies to address gaps and weaknesses in Europe's response to tuberculosis among migrants, advancing efforts to eliminate TB as a public health threat.

ERJ Open ResearchVol. 11(6)
Johannes Kepler University of Linz (AT), Universitat Autònoma de Barcelona (ES), The University of Sydney (AU), Universidade Federal do Rio Grande do Sul (BR), University Medical Center Groningen (NL), University Hospital Centre Zagreb (HR), Radboud University Nijmegen (NL), University of Turku (FI), Oregon Health & Science University (US), University of Groningen (NL), University of Zagreb (HR), Baylor College of Medicine (US), Universidade do Porto (PT), Universidade Politécnica do Cávado e do Ave (PT), TuBerculosis Vaccine Initiative (NL), P. D. Hinduja Hospital and Medical Research Centre (IN), University Hospital of Bern (CH), The Royal Free Hospital (GB), Instituto de Salud Carlos III (ES), Taronga Conservation Society Australia (AU), Radboud University Medical Center (NL), Westmead Hospital (AU), University of Belgrade (RS), Istituti Clinici Scientifici Maugeri (IT), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES), Center for Prevention and Treatment of Infections (US), Finnish Lung Health Association (FI), Centro de Investigación Biomédica en Red (ES), German Center for Infection Research (DE), Kepler Universitätsklinikum (AT), National Center for Tuberculosis and Lung Disease (GE), Algarve Biomedical Center (PT), Institutul de Pneumoftiziologie "Marius Nasta" (RO), Landesgesundheitsamt Baden-Württemberg (DE), Vall d'Hebron Hospital Universitari (ES), Research Center Borstel - Leibniz Lung Center (DE), Hospital Muñiz (AR), Zambia National Public Health Institute (ZM), Institute of Public Health of Serbia (RS), Hamburg Institut (Germany) (DE), Centre for Multidisciplinary Research in Health Science (IT), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (ES), National Institute of Health Dr. Ricardo Jorge (PT), Texas Children's Hospital (US), Hospital Universitari Germans Trias i Pujol (ES), Sociedad Española de Cardiología (ES), Goce Delcev University (MK), Northern State Medical University (RU), University College London (GB), Hamad Medical Corporation (QA), University of Lübeck (DE)
Openalex Percentile: Top 66%
Tuberculosis Research and Epidemiology
DOIOpen Access PDFOpenAlex
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