Re: Unified response is needed to tackle tuberculosis among refugees and migrants
Dear Editor
The article [1] provides a useful overview of the occurrence of tuberculosis (TB) infections among migrants, people living in asylums, etc. HIV infections and latent tuberculosis (TB) represent two critical challenges that must be tackled to achieve the eradication of TB. Furthermore, the incidence of HIV infections is notably greater among migrants when compared to non-migrants [2].
Both TB and HIV are infections that can occur simultaneously; for instance, in northern India, the frequency of TB in people with HIV is about 13 percent [3]. HIV/TB co-infections should also be treated and diagnosed early as part of a coordinated strategy to prevent TB. Individuals with HIV are ten times more likely to get tuberculosis, particularly multidrug-resistant TB, than those without HIV infections.
Inactive TB detection and shorter duration of two-drug treatment among migrants, homeless persons, and imprisoned persons are the essential components in preventing tuberculosis. Even BCG-vaccinated individuals should be treated for inactive tuberculosis, if they have contact history with the individuals suffering from active TB. Nearly one-quarter of global population has inactive tuberculosis, and that should be treated with short regimen (weekly isoniazid and rifapentine for 3-month); or else, ten percent of cases of inactive tuberculosis may develop active tuberculosis during their lifetime [4,5].
References
1. Kasaeva T, Dias H M, Mavhunga F, Viney K. Unified response is needed to tackle tuberculosis among refugees and migrants BMJ 2024; 387 :q2598 doi:10.1136/bmj.q2598
2. Santoso D, Asfia SKBM, Mello MB, Baggaley RC, Johnson CC, Chow EPF, Fairley CK, Ong JJ. HIV prevalence ratio of international migrants compared to their native-born counterparts: A systematic review and meta-analysis. EClinicalMedicine. 2022 Sep 17;53:101661. doi: 10.1016/j.eclinm.2022.101661.
3. Singh RK. Prevalence of HIV/Tb Co-infection among HIV Patients: Hospital Based Study from Northern Part of India. J Assoc Physicians India. 2017 Feb;65(2):106. PMID: 28457051.
4. Haley CA. Treatment of Latent Tuberculosis Infection. Microbiol Spectr. 2017 Apr;5(2). doi: 10.1128/microbiolspec.
5. Kim S, Thal R, Szkwarko D. Management of Latent Tuberculosis Infection. JAMA. 2023;329(5):421–422. doi:10.1001/jama.2022.24362
Competing interests:
No competing interests
02 December 2024
Ranjan Kumar Singh
Medical Doctor
Physician, formerly, Chief Medical Officer, Gaya, India.
Rapid Response:
Re: Unified response is needed to tackle tuberculosis among refugees and migrants
Dear Editor
The article [1] provides a useful overview of the occurrence of tuberculosis (TB) infections among migrants, people living in asylums, etc. HIV infections and latent tuberculosis (TB) represent two critical challenges that must be tackled to achieve the eradication of TB. Furthermore, the incidence of HIV infections is notably greater among migrants when compared to non-migrants [2].
Both TB and HIV are infections that can occur simultaneously; for instance, in northern India, the frequency of TB in people with HIV is about 13 percent [3]. HIV/TB co-infections should also be treated and diagnosed early as part of a coordinated strategy to prevent TB. Individuals with HIV are ten times more likely to get tuberculosis, particularly multidrug-resistant TB, than those without HIV infections.
Inactive TB detection and shorter duration of two-drug treatment among migrants, homeless persons, and imprisoned persons are the essential components in preventing tuberculosis. Even BCG-vaccinated individuals should be treated for inactive tuberculosis, if they have contact history with the individuals suffering from active TB. Nearly one-quarter of global population has inactive tuberculosis, and that should be treated with short regimen (weekly isoniazid and rifapentine for 3-month); or else, ten percent of cases of inactive tuberculosis may develop active tuberculosis during their lifetime [4,5].
References
1. Kasaeva T, Dias H M, Mavhunga F, Viney K. Unified response is needed to tackle tuberculosis among refugees and migrants BMJ 2024; 387 :q2598 doi:10.1136/bmj.q2598
2. Santoso D, Asfia SKBM, Mello MB, Baggaley RC, Johnson CC, Chow EPF, Fairley CK, Ong JJ. HIV prevalence ratio of international migrants compared to their native-born counterparts: A systematic review and meta-analysis. EClinicalMedicine. 2022 Sep 17;53:101661. doi: 10.1016/j.eclinm.2022.101661.
3. Singh RK. Prevalence of HIV/Tb Co-infection among HIV Patients: Hospital Based Study from Northern Part of India. J Assoc Physicians India. 2017 Feb;65(2):106. PMID: 28457051.
4. Haley CA. Treatment of Latent Tuberculosis Infection. Microbiol Spectr. 2017 Apr;5(2). doi: 10.1128/microbiolspec.
5. Kim S, Thal R, Szkwarko D. Management of Latent Tuberculosis Infection. JAMA. 2023;329(5):421–422. doi:10.1001/jama.2022.24362
Competing interests: No competing interests