P B Shete1, D Boccia2, P Dhavan3, N Gebreselassie4, K Lönnroth5, S Marks6, A Matteelli7, D L Posey8, M J van der Werf9, C A Winston5, C Lienhardt10. 1. Global Tuberculosis Programme, World Health Organization (WHO), Geneva, Switzerland, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, USA. 2. Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK. 3. International Organization of Migration, Geneva, Switzerland. 4. Global Tuberculosis Programme, World Health Organization (WHO), Geneva, Switzerland. 5. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. 6. Division of Tuberculosis Elimination, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA. 7. Department of Infectious and Tropical Diseases, WHO Collaborating Centre for TB/HIV collaborative activities and for the TB elimination strategy, University of Brescia, Brescia, Italy. 8. Division Global Quarantine and Migration, CDC, Atlanta, Georgia, USA. 9. European Centre for Disease Prevention and Control, Stockholm, Sweden. 10. Global Tuberculosis Programme, World Health Organization (WHO), Geneva, Switzerland, Institut de Recherche pour le Développement, Unité Mixte de Recherche 233, Montpellier, France.
Abstract
BACKGROUND: Pillar 3 of the End TB Strategy calls for the promotion of research and innovation at the country level to facilitate improved implementation of existing and novel interventions to end tuberculosis (TB). In an era of increasing cross-border migration, there is a specific need to integrate migration-related issues into national TB research agendas. The objective of the present review is to provide a conceptual framework to guide countries in the development and operationalization of a migrant-inclusive TB research agenda. METHODS: We conducted a literature review, complemented by expert opinion and the previous articles in this State of the Art series, to identify important themes central to migration-related TB. We categorized these themes into a framework for a migration-inclusive global TB research agenda across a comprehensive spectrum of research. We developed this conceptual framework taking into account: 1) the biomedical, social and structural determinants of TB; 2) the epidemiologic impact of the migration pathway; and 3) the feasibility of various types of research based on a country's capacity. DISCUSSION: The conceptual framework presented here is based on the key principle that migrants are not inherently different from other populations in terms of susceptibility to known TB determinants, but that they often have exacerbated or additional risks related to their country of origin and the migration process, which must be accounted for in developing comprehensive TB prevention and care strategies. A migrant-inclusive research agenda should systematically consider this wider context to have the highest impact.
BACKGROUND: Pillar 3 of the End TB Strategy calls for the promotion of research and innovation at the country level to facilitate improved implementation of existing and novel interventions to end tuberculosis (TB). In an era of increasing cross-border migration, there is a specific need to integrate migration-related issues into national TB research agendas. The objective of the present review is to provide a conceptual framework to guide countries in the development and operationalization of a migrant-inclusive TB research agenda. METHODS: We conducted a literature review, complemented by expert opinion and the previous articles in this State of the Art series, to identify important themes central to migration-related TB. We categorized these themes into a framework for a migration-inclusive global TB research agenda across a comprehensive spectrum of research. We developed this conceptual framework taking into account: 1) the biomedical, social and structural determinants of TB; 2) the epidemiologic impact of the migration pathway; and 3) the feasibility of various types of research based on a country's capacity. DISCUSSION: The conceptual framework presented here is based on the key principle that migrants are not inherently different from other populations in terms of susceptibility to known TB determinants, but that they often have exacerbated or additional risks related to their country of origin and the migration process, which must be accounted for in developing comprehensive TB prevention and care strategies. A migrant-inclusive research agenda should systematically consider this wider context to have the highest impact.
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