Screening for Latent Tuberculosis in Migrants – Status Quo and Future Challenges

This narrative review assessed the evidence that migrants from tuberculosis (TB) high-incidence countries migrating to TB low-incidence countries significantly contribute to active TB cases in the counties of destination, primarily through reactivation of latent TB. The different screening programs in the countries of destination are reviewed either based on screening and preventive treatment of latent TB pre or more commonly – post arrival. Screening can be performed using interferon-gamma release assays (IGRA) or tuberculin skin tests (TST). Preventive treatment of latent TB is using either monotherapy with isoniazid, or in combination with rifampicin or rifapentine. We review the ethical issues of preventive treatment in asymptomatic individuals and how these are addressed in different screening programs. We conclude that there is a lack of standardization and agreement on screening protocols, follow up and treatment.