Pediatric tuberculosis immigration screening in high-immigration, low-incidence countries.

BACKGROUND Tuberculosis (TB) screening in migrant children, including immigrants, refugees and asylum seekers, is an ongoing challenge in low TB incidence countries. Many children from high TB incidence countries harbor latent TB infection (LTBI), and some have active TB disease at the point of immigration into host nations. Young children who harbor LTBI have a high risk of progression to TB disease and are at a higher risk than adults of developing disseminated severe forms of TB with significant morbidity and mortality. Many countries have developed immigration TB screening programs to suit the needs of adults, but have not focused much attention on migrant children. OBJECTIVE To compare the TB immigration medical examination requirements in children in selected countries with high immigration and low TB incidence rates. DESIGN Descriptive study of TB immigration screening programs for systematically selected countries. RESULTS Of 18 eligible countries, 16 responded to the written survey and telephone interview. CONCLUSION No two countries had the same approach to TB screening among migrant children. The optimal evidenced-based manner in which to screen migrant children requires further research.