Workshop: Screening infectious diseases amongst migrants in Europe: The diversity of policies

Abstract

Abstract In Europe, the prevalence of several infectious diseases such as HIV, hepatitis B, hepatitis C and tuberculosis is higher amongst migrants. Late diagnosis of HIV, hepatitis B and C is a health issue that thwarts prevention efforts. Early diagnosis has obvious benefits, both for the individuals (i.e. earlier access to care with a better life expectancy) and for the community. As regard for HIV, treated patients with an undetectable viral load do not transmit the virus. This is in line with the UNAIDS 90-90-90 target that in every country 90% of people living with HIV should be aware of their positive status, 90% of them should be treated with antiretroviral and within 90% should have an undetectable viral load. Widespread testing of HIV, HBV and HCV is recommended by European guidelines, such those from European Centre for disease Prevention and Control (ECDC). The ECDC recommends that screening for HIV, hepatitis B, hepatitis C and tuberculosis should be offered to every migrant from countries with a high prevalence (≥1% for HIV and ≥2% for hepatitis B and C). Other recommendations include ensuring that screening and vaccination is voluntary and confidential, that migrants have a quick access to care, addressing barriers to screening, and taking into account the particular issues and needs of migrants. However, European countries have developed diverse guidelines and initiatives to address the issue of screening infectious diseases amongst migrants. The objective of this workshop is to present several European initiatives to improve the screening of infectious diseases amongst migrants. Four initiatives will be presented and discussed: screening of active tuberculosis amongst asylum seekers with the use of a questionnaire in Switzerland; replacing the systematic chest X-ray with a screening questionnaire for active tuberculosis and introducing rapid tests for HIV, HBV and HCV for all legal migrants at entry point in France, adding HIV, HBV and HCV testing to the compulsory targeted tuberculosis test in the Netherlands and offering targeted tests for latent tuberculosis, HBV and HCV to migrants registering for primary care in the UK. Key messages Screening of infectious diseases should be targeted to migrants from high-incidence countries. European practices should be harmonized.