I have read with interest the discussion over the last 24 hours or so, on this most fascinating subject of TB among migrants. Already the discussion has moved on from how to measure and analyse TB in migrants, to the complexities that contribute to how migrants present in terms of TB and other health matters but as Kedir Abdulsemed and Elizabeth Glarer contributions have already identified, migration is not a static phenomenon and that the transitory pathways are sometimes just of great a concern as the individual characteristics of the migrant. I have noted also that the discussion thread has not yet really picked up on the “TB carrier status” through latent TB and what this may mean and how we might measure and analyse this in migrants. I would be most interested to hear views from the TB community on this.
For those who do not know me – my area of work is in immigration and while this inevitably involves TB, it is the factors that contribute to “migration health” that interest me most. Noting that while a lot of the discussion has focussed on migration from high to low burden TB countries, it is important to note that most migration happens between high to high burden countries and even when travelling from high to low, the transitory pathways can take migrants back to high!!
In this context I would like to hear what contributors or other experts feel are the principle risk factors for active TB (or reactivation) and how they can be mitigated. Inevitably this will also need to address drug-resistance.
I have posted some publications including a few articles from an excellent series on migration in the 21st century that might stimulate some thinking of health determinants in migrants that might have some influence on risk factors for TB.
My apologies in advance for any delay in responding to your comments, given it is the middle of the night in Australia!! I will get back to you as soon as I can in the morning (my time)
Kind regards, Paul