Abstract

BackgroundTuberculosis (TB) elimination strategies in Australia require a focus on groups who are at highest risk of TB infection, such as immigrants from high‐burden settings. Understanding attitudes to different strategies for latent TB infection (LTBI) screening and treatment is an important element of justifiable elimination strategies.MethodTwo community panels were conducted in Melbourne with members of the Vietnamese (n = 11), Sudanese and South Sudanese communities (n = 9). Panellists were provided with expert information about LTBI and different screening and health communication strategies, then deliberated on how best to pursue TB elimination in Australia.FindingsBoth panels unanimously preferred LTBI screening to occur pre‐migration rather than in Australia. Participants were concerned that post‐migration screening would reach fewer migrants, noted that conducting LTBI screening in Australia could stigmatize participants and that poor awareness of LTBI would hamper participation. If targeted screening was to occur in Australia, the Vietnamese panel preferred ‘place‐based’ communication strategies, whereas the Sudanese and South Sudanese panel emphasized that community leaders should lead communication strategies to minimize stigma. Both groups emphasized the importance of maintaining community trust in Australian health service providers, and the need to ensure targeting did not undermine this trust.ConclusionPre‐migration screening was preferred. If post‐migration screening is necessary, the potential for stigma should be reduced, benefit and risk profile clearly explained and culturally appropriate communication strategies employed. Cultural attitudes to health providers, personal health management and broader social vulnerabilities of targeted groups need to be considered in the design of screening programs.

Highlights

  • The World Health Organization's (WHO) End TB Strategy aims to radically reduce the global incidence of tuberculosis (TB) by 2035 as a precursor to elimination.[1]

  • We report on two community panels, formed of members of the Vietnamese and Sudanese and South Sudanese communities who live in Melbourne, Australia

  • The Vietnamese and Sudanese and South Sudanese panels involved in this study were highly supportive of testing migrant groups for latent TB infection (LTBI), consistent with previous research indicating that new migrants accept most forms of infectious disease screening.[36,37]

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Summary

Introduction

The World Health Organization's (WHO) End TB Strategy aims to radically reduce the global incidence of tuberculosis (TB) by 2035 as a precursor to elimination.[1]. Panellists were provided with expert information about LTBI and different screening and health communication strategies, deliberated on how best to pursue TB elimination in Australia. Findings: Both panels unanimously preferred LTBI screening to occur pre-migration rather than in Australia. If targeted screening was to occur in Australia, the Vietnamese panel preferred ‘place-based’ communication strategies, whereas the Sudanese and South Sudanese panel emphasized that community leaders should lead communication strategies to minimize stigma. Both groups emphasized the importance of maintaining community trust in Australian health service providers, and the need to ensure targeting did not undermine this trust. If post-migration screening is necessary, the potential for stigma should be reduced, benefit and risk profile clearly

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