Abstract
Europe-wide collaboration for the identification and treatment of latent tuberculosis infection is important to further address and prevent tuberculosis among high-risk asylum seekers. To achieve this, existing barriers need to be addressed. https://bit.ly/2JoFiqx
From the authors:
We thank S. Villa and colleagues for their compliments on our work and are pleased to read that in Milan the latent tuberculosis (TB) infection (LTBI) screening and treatment of asylum seekers reach similar successful results.
We endorse that a culturally sensitive migrant-centred approach is crucial to a successful LTBI screening and treatment programme. Furthermore, we would like to emphasise the differences in approaches needed when working with different migrant groups. Our previously published paper on LTBI screening and treatment among regular immigrants, i.e. those applying for a non-tourist visa, showed different barriers, often related to a short planned stay of the immigrant in the Netherlands, to LTBI treatment acceptance and completion than those identified among asylum seekers [1].
By comparing the successful implementation in both the Dutch and the Italian setting, the authors show that indeed, and perhaps somewhat unexpected considering previous studies, LTBI screening and treatment among asylum seekers can be feasible and reach high levels of LTBI treatment acceptance and completion. Additionally, our recently accepted study among high-TB-risk migrants in the communities showed that although they are harder to reach for LTBI screening, LTBI treatment initiation and completion among those with LTBI diagnosis are also high [2]. We are currently analysing the cost-effectiveness of LTBI screening and treatment intervention, and will also assess if a similar approach among immigrants and asylum seekers from countries with a lower TB incidence would be cost-effective.
S. Villa and colleagues raise an important concern: the mobility of asylum seekers. We acknowledge the importance and necessity of a shared European Union (EU)-wide strategy to optimise effectiveness of tackling the high TB incidence among asylum seekers. As they recommend, a single database shared between European countries, such as already collected for four countries in the E-DETECT TB project, enables evaluation of the screening policies and comparison of the effectiveness of the approaches in various countries [3]. However, the current General Data Protection Regulation in the EU will not allow a shared data base through which patient follow-up can be achieved. Therefore, other solutions for cross-border collaboration and treatment support will be needed.
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Footnotes
Support statement: This work was supported by ZonMw, grant: 50-53000-98-128. Funding information for this article has been deposited with the Crossref Funder Registry.
Conflict of interest: I. Spruijt reports grants from The Netherlands Organisation for Health Research and Development (ZonMW), during the conduct of the study.
Conflict of interest: C. Erkens has nothing to disclose.
Conflict of interest: S. van den Hof has nothing to disclose.
Conflict of interest: F. Cobelens has nothing to disclose.
- Received February 28, 2020.
- Accepted March 21, 2020.
- Copyright ©ERS 2020