Imperial College London
Alternate

ProfessorJonFriedland

Faculty of Medicine, Department of Infectious Disease

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 3313 8521j.friedland Website

 
 
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Assistant

 

Ms Teyanna Gaeta +44 (0)20 3313 1943

 
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Location

 

8N21ACommonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hargreaves:2016:10.1016/j.cmi.2016.09.009,
author = {Hargreaves, S and Lönnroth, K and Nellums, LB and Olaru, ID and Nathavitharana, RR and Norredam, M and Friedland, JS},
doi = {10.1016/j.cmi.2016.09.009},
journal = {Clinical Microbiology and Infection},
pages = {141--146},
title = {Multidrug-resistant tuberculosis and migration to Europe},
url = {http://dx.doi.org/10.1016/j.cmi.2016.09.009},
volume = {23},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Multidrug-resistant tuberculosis (MDR-TB) in low-incidence countries in Europe is more prevalent among migrants than the native population. The impact of the recent increase in migration to EU and EEA countries with a low incidence of TB (fewer than 20 cases per 100,000 [1]) on MDR-TB epidemiology is unclear. This narrative review synthesises evidence on MDR-TB and migration identified through an expert panel and database search. A significant proportion of MDR-TB cases in migrants result from reactivation of latent infection. Refugees and asylum seekers may have a heightened risk of MDR-TB infection and worse outcomes. Although concerns have been raised around ‘health tourists’ migrating for MDR-TB treatment, numbers are probably small and data are lacking. Migrants experience significant barriers to testing and treatment for MDR-TB, exacerbated by increasingly restrictive health systems. Screening for latent MDR-TB is highly problematic since current tests cannot distinguish drug-resistant latent infection, and evidence-based guidance for treatment of latent infection in contacts of MDR patients lacking. While there is evidence that transmission of TB from migrants to the general population is low – it predominantly occurs within migrant communities – there is a human rights obligation to improve the diagnosis, treatment, and prevention of MDR-TB in migrants. Further research is needed into MDR-TB and migration, the impact of screening on detection or prevention, and the potential consequences of failing to treat and prevent MDR-TB among migrants in Europe. An evidence-base is urgently needed to inform guidelines for effective approaches for MDR-TB management in migrant populations in Europe.
AU  - Hargreaves,S
AU  - Lönnroth,K
AU  - Nellums,LB
AU  - Olaru,ID
AU  - Nathavitharana,RR
AU  - Norredam,M
AU  - Friedland,JS
DO  - 10.1016/j.cmi.2016.09.009
EP  - 146
PY  - 2016///
SN  - 1469-0691
SP  - 141
TI  - Multidrug-resistant tuberculosis and migration to Europe
T2  - Clinical Microbiology and Infection
UR  - http://dx.doi.org/10.1016/j.cmi.2016.09.009
UR  - http://hdl.handle.net/10044/1/41035
VL  - 23
ER  -
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