Admin_Adham
TOPLINE
A national screening programme in Netherlands identified tuberculosis (TB) in 239 individuals over 5 years, with yields of 79 per 100,000 among immigrants and 276 per 100,000 among asylum seekers. Only 27.2% of pulmonary TB cases identified through screening reported cough symptoms.
METHODOLOGY
- Researchers in Netherlands conducted a retrospective study using linked register data to evaluate the national TB and TB infection (TBI) screening programme for migrant groups, with the aim of assessing TB detection rates, TBI prevalence, and treatment initiation and outcomes.
- They included 149,214 migrants screened between 2019 and 2023, of whom 87,511 were immigrants (66.8% aged 18-34 years; 53.0% female individuals) and 61,703 were asylum seekers (52.0% aged 18-34 years; 30.1% female individuals).
- Among immigrants from countries with a TB incidence of 100 or more per 100,000 population, those aged 18 years or older were screened using chest x-ray and those younger than 18 years were screened using a symptom checklist combined with a tuberculin skin test (with interferon-gamma release assay confirmation if positive). Asylum seekers from countries with a TB incidence of 50 or more per 100,000 population underwent chest x-ray screening at entry.
- Cases were considered bacteriologically confirmed if acid-fast bacilli were seen on microscopy, polymerase chain reaction was positive for the Mycobacterium tuberculosis complex, or culture confirmed the M tuberculosis complex.
TAKEAWAY
- TB was diagnosed in 69 immigrants and 170 asylum seekers, corresponding to yields of 79 per 100,000 screened (95% CI, 62-100) and 276 per 100,000 screened (95% CI, 237-320), respectively.
- Among 202 cases of pulmonary TB, 129 (63.9%) were bacteriologically confirmed, and only 55 (27.2%) reported cough symptoms; asylum seekers were more likely to report cough than immigrants (32.6% vs 13.8%; P < .05).
- Treatment completion was higher among immigrants than among asylum seekers (92.8% vs 81.2%).
- Among 20,378 immigrants screened for TBI, the prevalence rose steadily with age: from 0.6% in children younger than 12 years to 4.4% in those aged 12-17 years and 12.9% in adults. Among them, 64.6%, 81.5%, and 64.7%, respectively, initiated and completed treatment.
IN PRACTICE
"This evaluation supports the role of targeted migrant screening as a core component of TB prevention and elimination strategies in low-incidence settings," the authors wrote.
SOURCE
The study was led by Gerard de Vries, National Institute for Public Health and the Environment, Utrecht, Netherlands. It was published online on September 08, 2026, in The Lancet Regional Health - Europe.
LIMITATIONS
Screening coverage could not be calculated because the actual number of migrants eligible for screening was unknown. The study used country of birth as a proxy for nationality due to missing data on nationality. TB cases may have been underascertained due to incomplete linkage between the TB client information system and the Netherlands TB Register, and TBI reporting was incomplete because registration is voluntary rather than mandatory.
DISCLOSURES
This study was supported by the Ministry of Health, Welfare and Sport, Netherlands. The authors reported having no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
