Tuberculosis in migrant children and adolescents in Europe: a joint TBnet and ptbnet systematic review and meta-analysis.

BACKGROUND

Migrant children face an elevated risk of active tuberculosis (TB) after acquisition of Mycobacterium tuberculosis infection in their country of origin or during migration, which often involves overcrowded, suboptimal living conditions. The risk for M. tuberculosis infection and TB among migrant children in the European Union, European Economic Area, and United Kingdom (EU/EEA & UK) has not been evaluated systematically.

OBJECTIVE

We aimed to identify the prevalence of M. tuberculosis infection and TB disease among migrant children in the EU/EEA & UK.

METHODS

Data sources: We searched MEDLINE, OVID, and SCOPUS databases.

STUDY ELIGIBILITY CRITERIA: We included randomized controlled trials, cohort, and case-control studies published before December 2024.

PARTICIPANTS

The included studies enrolled migrant children (0-18 years) being evaluated for M. tuberculosis infection or TB disease at the time of entry in the EU/EEA & UK.

INTERVENTION: Assessment of risk of bias: Quality assessment was performed using the Newcastle-Ottawa score. Methods of data synthesis: Random effects meta-analysis was completed to identify pooled prevalence estimates for both conditions.

RESULTS

Among 25 studies analysed, the pooled estimate of M. tuberculosis infection in the absence of active TB in migrant children was 10.1% (95% CI: 7.5-13.1%). Among 12 studies reporting on TB, the pooled estimate TB prevalence in migrant children was 0.9% (95% CI: 0.7-1.1%). The pooled estimate TB prevalence was 0.8% (95% CI: 0.5-1.2) in accompanied minors and 0.9% (95% CI: 0.7-1.3) in unaccompanied minors. There was high heterogeneity and moderate risk of bias across studies.

CONCLUSIONS

The burden of M. tuberculosis infection and TB disease in migrant children arriving in the EU/EEA & UK is substantial. Recommendations should be formulated to enhance targeted interventions, inform policies, and guide best practices for the prevention, diagnosis, and treatment of TB in migrant children across the EU/EEA & UK.