New S3 Guideline on Tuberculosis Prevention Among New Migrants Published
This digitally colorized scanning electron microscopic (SEM) image, depicts a large group of orange-colored, rod shaped, Mycobacterium tuberculosis bacteria, which cause tuberculosis (TB) in human beings.
Just in time for today’s World Tuberculosis Day, the new S3 guideline on tuberculosis prevention among newly arrived migrants has gone online at the Association of Scientific Medical Societies (AWMF). Commissioned by the German Respiratory Society (DGP), it was developed under the leadership of the German Central Committee for Tuberculosis Control (DZK) and the Helmholtz Centre for Infection Research (HZI), with the participation of the German Centre for Infection Research (DZIF). Over the past three years, a team of experts in public health and personalized medicine has been working alongside people affected by the disease to improve tuberculosis screening—and thus prevention—in Germany. The guideline was funded by the Innovation Fund of the Joint Federal Committee (G-BA).
“The current national strategy for tuberculosis control is insufficient,” emphasizes the lead author, Dr. Brit Häcker, a pulmonologist and medical staff member at the DZK as well as a researcher in the department “Epidemiology” at the HZI. “We therefore propose a complete restructuring of the current approach with our S3 guideline.”
Only those living in shared housing are screened for tuberculosis
Häcker and her colleagues point out that, under current law, every migrant is required to undergo tuberculosis screening if they are housed in shared accommodation. “Since no accompanying circumstances are taken into account, this results in many unnecessary screenings in shared housing on the one hand, and a lack of screening opportunities for all people in other types of housing on the other,” explains the pulmonologist and tuberculosis expert. It is important to take into account the circumstances of newly arrived migrants, the authors write.
Offer screening to people from countries with high tuberculosis incidence
Accordingly, the new recommendations state: In particular, newly arrived migrants from countries with a tuberculosis incidence of more than 100 per 100,000 inhabitants should be offered a tuberculosis screening. For people up to age 35, an additional screening for tuberculosis infection (TBI) should be conducted. If TBI is detected, an offer for preventive drug therapy should also be made.
Risk factors such as comorbidities and pre-existing conditions, malnutrition, or difficult refugee circumstances should also be taken into account in order to offer targeted screening to people at the highest risk of tuberculosis or TB infection. “This allows us to use available resources much more efficiently and in a more targeted manner,” says Brit Häcker.
Improving control strategies, providing needs-based and targeted services, and making better use of available resources
Thus, the scientific guideline is aimed not only at physicians but also at policymakers. “We have worked with numerous experts to develop this guideline, which establishes an evidence-based framework for the prevention and treatment of tuberculosis among migrants that is unique in Europe,” says Prof. Berit Lange, the scientific lead of the guideline. The DZIF scientist is head of the department “Epidemiology” at the HZI and professor of infectious disease epidemiology at Hannover Medical School (MHH) and appeals to Berlin: “Use this recommendation, developed by many experts, to prevent not only individual suffering but also the further spread of tuberculosis!”
In the medium term, the strategy outlined in the new S3 guideline even offers Germany the opportunity to become one of the first countries in the world to be TB-free. German policymakers have already committed to this international goal—the EndTB strategy—at high-level United Nations meetings on tuberculosis in 2018 and 2023. “We are showing how it can be done,” say Häcker and Lange on behalf of the entire team of authors. “The expertise is right here!”
Quelle: Press release from the German Respiratory Society (in German)
Further information:
S3 Guideline on Tuberculosis Prevention in Newly Arrived Migrant (TB-Risk) (in German)
