New vision needed for combating and preventing TB among migrants

May 18, 2010

Tuberculosis (TB) is an enormous global public health problem. Migration and failure by governments and the public health community to adequately treat and prevent TB among migrants is an important barrier to TB control.

To reduce the incidence, spread and severity of tuberculosis, government policies must ensure that all patients have easy access to diagnosis and treatment, according to a commentary entitled "TB on the Move" in this month's The Lancet.

Henry M. Blumberg, MD, professor of medicine (infectious diseases) at Emory University School of Medicine and Grady Memorial Hospital was lead author of the commentary in a special Lancet series on tuberculosis. Other contributors were from the WHO Collaborating Center for TB and Lung Diseases, the Care and Research Institute, Partners in Health, and the Norwegian Institute of Public Health.

Nearly one billion people - or one in seven globally - are , say the authors, with 740 million internal migrants and 200 million international migrants. Most of the international migrants (130 million) are moving from a developing to a developed country.

"Migrants are disproportionately affected by TB, a reflection of the high rate of disease in their country of origin due to poverty and made worse by limited health-care and public health infrastructure," says the commentary.

High-income countries have a low incidence of TB, and most cases in these countries, including multi-drug resistant TB, now occur in migrants. Thus enhancing global TB control is in their self-interest and is cost-effective.

"Unfortunately, governmental public policies towards migrants have been antagonistic to TB control efforts by furthering stigma and marginalization," say the authors. Most migrants are missed by TB screening programs, leading to much worse outcomes and cure rates.

"A new vision on health and migration is necessary if we want to go beyond what (little) is done today," states the commentary. "Each country should first ensure that, everywhere, all patients with tuberculosis have easy access to diagnosis and treatment free of charge, and that undocumented migrants are not deported until completion of treatment, as stated by the International Union Against Tuberculosis and ."

This new vision must help prevent inequalities in health outcomes by increasing surveillance (with built-in confidentiality), early diagnosis and treatment, and investment in new drugs, diagnostics and a vaccine.

Finally, the authors state, "In view of globalization and migration, the mantra 'tuberculosis anywhere is everywhere' rings true."

Explore further: Study IDs risk factors for severe hidradenitis suppurativa

add to favorites email to friend print save as pdf

Related Stories

Drug-resistant tuberculosis rife in China

Dec 11, 2008

Levels of drug-resistant tuberculosis (TB) in China are nearly twice the global average. Nationwide research published in the open access journal BMC Infectious Diseases has shown that almost 10% of Chinese TB cases are re ...

WHO warns of drug-resistant TB

Sep 06, 2006

The World Health Organization in Switzerland has warned of a new strain of tuberculosis that is rapidly spreading and cannot be treated with current drugs.

HIV/AIDS linked to drug resistant TB

Nov 16, 2006

U.S. scientists say a highly drug-resistant form of tuberculosis has been linked to HIV/AIDS in a study conducted in rural South Africa.

Experts say Toronto unprepared for TB

Feb 24, 2008

Health experts warn there could be an outbreak of tuberculosis in Toronto, which reportedly lacks a centralized system of TB clinics.

Recommended for you

Ivory Coast closes borders with Ebola-hit neighbours

1 hour ago

The Ivory Coast has closed its borders with Ebola-hit Guinea and Liberia in a bid to protect citizens against an epidemic that has killed 1,427 people across West Africa, the prime minister said Saturday.

How the world is underestimating Ebola: WHO

10 hours ago

The Ebola epidemic tearing through western Africa is by far the deadliest known outbreak of the disease, yet the magnitude of the spread is believed to be severely underestimated.

Last Ebola-free region of Liberia falls to virus

10 hours ago

Every region of Liberia has now been hit by Ebola, officials said Friday, as the World Health Organization warned the fight against the worst-ever outbreak of the killer disease would take months.

Ebola death toll rises to 1,427: WHO

20 hours ago

The death toll from the Ebola outbreak sweeping through west African countries has risen to 1,427 out of more than 2,600 cases, the World Health Organization said Friday.

User comments : 0