Tuberculosis, migration and ethnicity
Migrants are often over-represented among new TB notifications in low incidence countries, including in England, where migrants represent almost 80% of new cases. This phenomenon is largely reflecting epidemiology in countries of origin and transit, as well as adverse circumstances along the migration route and arrival. Interventions, including screening for TB infection and disease have been tested, but more work is needed to develop more effective and cost-effective interventions. Research from our team has informed migrant screening programmes nationally and internationally and modelled screening algorithms and developed novel service models for TB infection treatment follow up in primary care. A separate program of work focuses on understanding host, microbiological and environmental determinants of ethnic variation in TB presentation and outcomes.
Outputs
- Zenner D, Haghparast-Bidgoli H, Chaudhry T, et al. How to diagnose TB in migrants? A systematic review of reviews and decision tree analytical modelling exercise to evaluate properties for single and combined TB screening tests. Eur Respir J 2025; : 2402000.
- Kunst H, Lange B, Hovardovska O, et al. Tuberculosis in adult migrants in Europe: a TBnet consensus statement. European Respiratory Journal [Internet] European Respiratory Society; 2025 [cited 2025 Mar 25]; 65. Available from: https://publications.ersnet.org/content/erj/65/3/2401612.
- Vasiliu A, Cristea V, Stoycheva K, et al. Shifting tuberculosis dynamics in the EU/EEA: geographical and drug resistance trends among people of foreign origin, 2019 to 2023. Eurosurveillance European Centre for Disease Prevention and Control; 2025; 30: 2500173.
- Burman M, Zenner D, Copas AJ, et al. The treatment of latent tuberculosis infection in migrants in primary care versus secondary care. Eur Respir J England; 2024; : 2301733.
- Zenner D, Brals D, Nederby-Öhd J, et al. Drivers determining tuberculosis disease screening yield in four European screening programmes: a comparative analysis. Eur Respir J England; 2023; 62.
- Coussens AK, Wilkinson RJ, Nikolayevskyy V, Elkington PT, Hanifa Y, Islam K, Timms PM, Bothamley GH, Claxton AP, Packe GE, Darmalingam M, Davidson RN, Milburn HJ, Baker LV, Barker RD, Drobniewski FA, Mein CA, Bhaw-Rosun L, Nuamah RA, Griffiths CJ, Martineau AR. Ethnic variation in inflammatory profile in tuberculosis. PLoS Pathog. 2013;9(7):e1003468.
- Pareek M, Innes J, Sridhar S, Grass L, Connell D, Woltmann G, Wiselka M, Martineau AR, Kon OM, Dedicoat M, Lalvani A. Vitamin D deficiency and TB disease phenotype. Thorax. 2015;70(12):1171-80.
Projects
- A systematic review and meta-analysis update, evaluating the efficacy and safety of latent tuberculosis treatment regimens through Bayesian network analysis. PROSPERO: CRD42025625353
- Incidence of Mycobacterium tuberculosis infection and tuberculosis in migrant children in Europe 2024 CRD42024532325 (Ongoing) KunstH
- The yield of active tuberculosis (TB) from screening migrant populations for latent tuberculosis infection (LTBI): a systematic review 2018 CRD42018086029 KunstH
- Tuberculosis in migrants in Europe and social determinants 2024 CRD42024601015 Kunst H
- Prevalence of hepatitis B and C co-infection among patients with tuberculosis including latent tuberculosis infection and prevalence of drug induced liver injury (DILI) with anti-tuberculosis treatment in co-infected patients (a systematic review) 2025 CRD42025603960 KunstH