A multinational Delphi consensus on TB screening of migrants in Europe

The disproportionate burden of tuberculosis among migrants in the World Health Organization European Region underscores the urgent need to address the public health challenges associated with global migration. Recommendations for screening of pulmonary tuberculosis (TB) and TB infection (TBI) are highly variable across European countries, highlighting the need for standardized practices and coordinated efforts to reduce tuberculosis risk more effectively. This study aims to produce an harmonized set of recommendations to contribute to elaboration for policy action using Delphi method. It brings together a multidisciplinary panel of 33 tuberculosis experts from academia, healthcare, non-governmental organizations, and government agencies across 22 countries to formulate consensus-based recommendations. The panel created 19 consensus statements and 36 recommendations for governments, health systems, and other stakeholders. The recommendations span four key domains: 1) policy, 2) health systems and health professionals, 3) screening procedures and priority populations, and 4) continued treatment and care. This study recommends a unified, evidence-based approach to TB screening in migrants, with free access to diagnosis and treatment, culturally sensitive care, use of digital tools, and coordinated efforts across health systems to ensure effective and equitable TB control in Europe. Thus, the experts emphasized key recommendations that strike a balance between immediate health system interventions, screening procedures, and cultural inclusivity to more effectively address tuberculosis among migrants. The findings of this study offer actionable policies to address gaps and weaknesses in Europe's response to tuberculosis among migrants, advancing efforts to eliminate TB as a public health threat.