XXXX Infection Screening in Immigrants to Low-Incidence Countries: A Meta-Analysis.

@entity9178 @entity378 @entity379
BACKGROUND: Immigration from regions with a high incidence of @entity378 ( @entity378 ) has slowed the decline of @entity378 in low-incidence regions. Targeted screening of new immigrants and treatment for @entity9178 ( @entity9178 ) is needed to reinvigorate this decline. This meta-analysis compares @entity9178 diagnostic tests by positive test prevalence and proportion of positive tests by @entity378 incidence. METHODS: A systematic literature search was performed and data extracted based on tuberculin skin test (TST) and/or @entity379 release assay (IGRA) use in immigrants. For the eight studies performing tests concurrently, data were compared by positive tests and concordance, while other studies comparing individual tests were analyzed based on demographic factors. Data were analyzed via meta-analysis. RESULTS: Forty-five studies with a combined sample size of 93,249 individuals were included in the analyses, 2206 of which were from the eight concurrent studies. Odds of a positive TST were significantly higher than an IGRA (odds ratio 1.46; 95  % confidence interval 1.07-2.01) and test agreement was moderate. Proportion of positive TST and IGRA tests increased with @entity378 incidence, although not linearly. CONCLUSION: TST and IGRA data relating to immigrants are lacking, especially long-term follow-up and comparative data. Further data are urgently needed to determine @entity378 risks after immigration, long-term @entity378 development, and treatment outcomes.
