ArticleThe Lancet. Infectious diseases2011
Screening of immigrants in the UK for imported latent tuberculosis: a multicentre cohort study and cost-effectiveness analysis.
Article in The Lancet. Infectious diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 9 of them syntheses that pooled it.
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Who cites it
90 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Prevalence and risk factors for key infectious diseases amongst migrants to the UK: a systematic review.BMC infectious diseases · 2026Pooled it
- Prevalence of Tuberculosis among migrants under national screening programs: a systematic review and meta-analysis.Global health research and policy · 2025Pooled it
- Systematic review of latent tuberculosis infection research to inform programmatic management in Ireland.Irish journal of medical science · 2022Pooled it
- Recommendations for the screening of paediatric latent tuberculosis infection in indigenous communities: a systematic review of screening strategies among high-risk groups in low-incidence countries.BMC public health · 2018Pooled it
- The effectiveness and cost-effectiveness of screening for latent tuberculosis among migrants in the EU/EEA: a systematic review.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2018Pooled it
- Cost Effectiveness of Preventive Treatment for Tuberculosis in Special High-Risk Populations.PharmacoEconomics · 2015Pooled it
- Latent tuberculosis infection screening in immigrants to low-incidence countries: a meta-analysis.Molecular diagnosis & therapy · 2015Pooled it
- A systematic review on TST and IGRA tests used for diagnosis of LTBI in immigrants.Molecular diagnosis & therapy · 2015Pooled it
- Pooled it
- Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece.BMC pediatrics · 2017Trial
- Screening for latent TB, HIV, and hepatitis B/C in new migrants in a high prevalence area of London, UK: a cross-sectional study.BMC infectious diseases · 2014Trial
- [Tuberculosis screening in young migrants from Mali: concordance between Mantoux and QuantiFERON® in Primary Care].Atencion primaria · 2026Article
- Impact of detection rate and preventive treatment of latent tuberculosis infection on the future burden of tuberculosis among students in shanghai: a predictive study using Markov modeling.BMC public health · 2025Article
- Screening for latent tuberculosis infection in patients with chronic kidney disease: a review of evidence and current practice in the UK.Clinical kidney journal · 2025Review
- Community-based testing of migrants for infectious diseases (COMBAT-ID): observational cohort study measuring the effectiveness of routine testing for infectious diseases among migrants attending primary care.EClinicalMedicine · 2025Article
- Enhanced screening for tuberculosis infection among immigrants in southern New Brunswick: A cross-sectional pilot study.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2025Article
- The impact of latent tuberculosis screening programmes for migrant populations in high income, low burden countries.PloS one · 2025Article
- Incidence of Tuberculosis Among Immigrants in Korea Who Participated in a Latent Tuberculosis Infection Screening Program.Journal of Korean medical science · 2024Article
- The Yield of Active Tuberculosis Disease and Latent Tuberculosis Infection in Tuberculosis Household Contacts Investigated Using Chest X-ray in Yogyakarta Province, Indonesia.Tropical medicine and infectious disease · 2024Article
- Systematic review of the economic impact of novel Mycobacterium tuberculosis specific antigen-based skin tests for detection of TB infection compared with tuberculin skin test and interferon-gamma release assays.PLOS global public health · 2024Article
30 more citing papers are in PubMed but not listed here.
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8 authors.
Funding
Abstract
backgroundContinuing rises in tuberculosis notifications in the UK are attributable to cases in foreign-born immigrants. National guidance for immigrant screening is hampered by a lack of data about the prevalence of, and risk factors for, latent tuberculosis infection in immigrants. We aimed to determine the prevalence of latent infection in immigrants to the UK to define which groups should be screened and to quantify cost-effectiveness.
methodsIn our multicentre cohort study and cost-effectiveness analysis we analysed demographic and test results from three centres in the UK (from 2008 to 2010) that used interferon-γ release-assay (IGRA) to screen immigrants aged 35 years or younger for latent tuberculosis infection. We assessed factors associated with latent infection by use of logistic regression and calculated the yields and cost-effectiveness of screening at different levels of tuberculosis incidence in immigrants' countries of origin with a decision analysis model.
findingsResults for IGRA-based screening were positive in 245 of 1229 immigrants (20%), negative in 982 (80%), and indeterminate in two (0·2%). Positive results were independently associated with increases in tuberculosis incidence in immigrants' countries of origin (p=0·0006), male sex (p = 0·046), and age (p < 0·0001). National policy thus far would fail to detect 71% of individuals with latent infection. The two most cost-effective strategies were to screen individuals from countries with a tuberculosis incidence of more than 250 cases per 100,000 (incremental cost-effectiveness ratio [ICER] was £17,956 [£1=US$1·60] per prevented case of tuberculosis) and at more than 150 cases per 100,000 (including immigrants from the Indian subcontinent), which identified 92% of infected immigrants and prevented an additional 29 cases at an ICER of £20,819 per additional case averted.
interpretationScreening for latent infection can be implemented cost-effectively at a level of incidence that identifies most immigrants with latent tuberculosis, thereby preventing substantial numbers of future cases of active tuberculosis.
fundingMedical Research Council and Wellcome Trust.
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