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The WHO European Region has faced high rates of external and internal migration in recent years, with concerns that this is contributing to the burden of tuberculosis (TB), multidrug-resistant TB (MDR-TB) and TB/HIV coinfection in some countries. This report examines evidence of effective and efficient service packages for the prevention, diagnosis and treatment of TB to inform strategies to address the TB burden in refugee and migrant populations. Significant regional variations were identified in both migration levels and TB burden in refugees and migrants, as well as in approaches to TB control, with low quality of evidence in many cases. While it is unlikely that a single strategy/package will be effective for all situations, the evidence highlights some common approaches that could guide policy-making and service development. TB elimination targets for the Region will not be met unless inequalities in access to screening and treatment for migrants are addressed, alongside efforts to tackle TB globally.
Worldwide, more people are on the move now than ever before, yet many refugees and migrants face poorer health outcomes than the host populations. Addressing their health needs is, therefore, a global health priority and integral to the principle of the right to health for all. The key is to strengthen and maintain health systems by ensuring that they are refugee- and migrant-sensitive and inclusive. Health outcomes are influenced by a whole host of determinants. However, refugees and migrants face additional determinants such as precarious legal status; discrimination; social, cultural, linguistic, administrative and financial barriers; lack of information about health entitlements; low health literacy; and fear of detention and deportation. This groundbreaking publication outlines current and future opportunities and challenges and provides several strategies to improve the health and well-being of refugees and migrants. It is an advocacy tool for national and international policy-makers involved in health and migration. Evidence on the health of refugees and migrants remains fragmented – comparable data across countries and over time are urgently needed to track progress towards the health-related United Nations Sustainable Development Goals. With only 8 years until the 2030 target date to transform our world, the time to act is now.
Recent years have witnessed key developments in the diagnosis and treatment of tuberculosis. Alongside this, and running in direct opposition to this progress, was the COVID-19 pandemic, which had an unprecedented detrimental effect on tuberculosis control and the achievement of targets set by the End TB Strategy. This timely and important Monograph provides a crucial update on recent changes, developments and setbacks in the field, and calls for a re-commitment to the achievement of the End TB Strategy and Sustainable Development Goals. Written by authors from across the world, the Monograph covers: diagnosis; advances in treatment; prevention; and tuberculosis control challenges in different populations and contexts.
This richly illustrated book is a comprehensive guide to the dermatologic disorders that may be encountered in refugees and other migrants. It will equip readers to diagnose and treat a diverse range of skin diseases and conditions, including, but not limited to, infections caused by bacteria, viruses, fungi, and parasites, dermatologic manifestations of sexually transmitted diseases, dermatoses associated with malnutrition, pigmentary disorders, bullous diseases, connective tissue diseases, and benign and malignant cutaneous neoplasias. Attention is drawn to various neglected tropical skin diseases and to the characteristic signs of torture and genital mutilations. Helpful information is also provided on the significance of skin color and the relevance of ethnic and genetic factors. The clinical chapters are complemented by discussion of the circumstances that give rise to migration, such as poverty, war, and environmental conditions. This enables the reader to gain a more rounded understanding of patients’ circumstances that in turn will positively impact on patient care. This book will be of wide interest to dermatologists, whether experienced or in training, as well as to general physicians and researchers.
BACKGROUND: Latent tuberculosis infection (LTBI), defined as a state of persistent immune response to prior-acquired Mycobacterium tuberculosis antigens without evidence of clinically manifested active TB, affects about one-third of the world's population. Approximately 10% of people with LTBI will develop active TB disease in their lifetime, with the majority developing it within the first five years after initial infection. Currently available treatments have an efficacy ranging from 60% to 90%. Systematic testing and treatment of LTBI in at-risk populations is a critical component of WHO's eight-point framework adapted from the End TB Strategy to target pre-elimination and, ultimately, elimination in low incidence countries. OVERVIEW: Recognizing the importance of expanding the response to LTBI, in 2014 WHO developed Guidelines on the Management of Latent Tuberculosis Infection. The guidelines are primarily targeted at high-income or upper middle-income countries with an estimated TB incidence rate of less than 100 per 100 000 population, because they are most likely to benefit from it due to their current TB epidemiology and resource availability. The overall objective of the guidelines is to provide public health approach guidance on evidence-based practices for testing, treating and managing LTBI in individuals with the highest risk of progression to active disease. Specific objectives include identifying and prioritizing at-risk population groups for targeted intervention of LTBI testing and treatment, including defining an algorithm, and recommending specific treatment options. The guidelines are expected to provide the basis and rationale for the development of national guidelines for LTBI management based on available resources, epidemiology of TB including intensity of transmission, the health-care delivery system of the country, and other national and local determinants.
WHO's Global Tuberculosis Report provides a comprehensive and up-to-date assessment of the TB epidemic and of progress in care and prevention at global, regional and country levels. This is done in the context of recommended global TB strategies and associated targets, and broader development goals. For the period 2016-2035, these are WHO's End TB Strategy and the United Nations' (UN) Sustainable Development Goals (SDGs), which share a common aim: to end the global TB epidemic. The main data sources for the report are annual rounds of global TB data collection implemented by WHO's Global TB Program since 1995 and databases maintained by other WHO departments, UNAIDS and the World Bank. In WHO's 2017 round of global TB data collection, 201 countries and territories that account for over 99% of the world's population and TB cases reported data.