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@article{Nellums:2017,
author = {Nellums, LB and Rustage, K and Hargreaves, S and Friedland, J},
journal = {BMC Medicine},
title = {MDR-TB treatment adherence in migrants: a systematic review and meta-analysis},
url = {http://hdl.handle.net/10044/1/55527},
year = {2017}
}

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TY  - JOUR
AB  - Background: MDR-TB is a growing concern in meeting globaltargets for TB control. In high-income low TB-incidence countries,a disproportionate number of MDR-TB cases occur in migrant(“foreign born”) populations, with concerns about low adherence rates in these patients compared to the host non-migrant population. Tackling MDR-TB in this context may therefore require unique approaches. We conducted a systematic review and meta-analysis to identify and synthesise data on MDR-TB treatment adherence in migrant patients to inform evidence-based strategies to improve care pathways and health outcomes in this group.Methods: This systematic review and meta-analysis was conducted in line with PRISMA guidelines (PROSPERO 42017070756). The databases Embase, Medline, Global Health and PubMed were searched to 24 May 2017 for primary research reporting MDR-TB treatment adherence and outcomes in migrant populations, with no restrictions on dates or language. Meta-analysis was conducted using random-effects models. Results: From 413 papers identified in the database search, 15 studies reporting on MDR-TB treatment outcomes for 258 migrants and 174 non-migrants, were included in the systematic review and meta-analysis. The estimated rate of adherence to MDR-TB treatment across migrant patients was 71% (95% CI:58-84%), with non-adherence reported among 20% (95% CI:4-37%) of migrant patients. A key finding was there were no Differences in estimated rates of adherence (RR = 1.05; 95% CI:0.82-1.34) or non-adherence (RR = 0.97; 95% CI:0.79-1.36) between migrants and non-migrants.Conclusions: MDR-TB treatment adherence rates among migrants in high-income low TB-incidence countries are approachingglobal targets for treatment success (75%), and are comparable to rates in non-migrants. The findings highlight that only just over 70% of migrant and non-migrant patients adhere to MDR-TB treatment. The results point to the importance of increasing adherence in all patient groups, incl
AU  - Nellums,LB
AU  - Rustage,K
AU  - Hargreaves,S
AU  - Friedland,J
PY  - 2017///
SN  - 1741-7015
TI  - MDR-TB treatment adherence in migrants: a systematic review and meta-analysis
T2  - BMC Medicine
UR  - http://hdl.handle.net/10044/1/55527
ER  -

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