Dhavan P, Dias H M, Creswell J, Weil D
International Organization for Migration, Geneva.
Global TB Programme, World Health Organization, Geneva.
Int J Tuberc Lung Dis. 2017 Jun 1;21(6):610-623. doi: 10.5588/ijtld.16.0917.
With nearly one billion migrants worldwide, migration is both a dynamic and a divisive phenomenon facing the world today. Migrants are a heterogeneous group, and the conditions surrounding migration pathways often pose risks to the physical, mental and social well-being of migrants, with certain subgroups being more vulnerable than others. Several determinants of health and tuberculosis (TB) interplay to increase the vulnerability of migrants to tuberculous infection, TB disease and poor treatment outcomes, making them a key population for TB. This article is the first in the State-of-the-Art series of the International Journal of Tuberculosis and Lung Disease on TB and migration. It provides an overview of migration trends, migration pathways and social determinants, and impact on TB. This article outlines a framework for the prevention and reduction of the TB burden among migrants, adapted from the World Health Organization's End TB Strategy, and in accordance with the Stop TB Partnership's Global Plan and the Sustainable Development Goals (SDGs) agenda. The framework highlights the need for migrant-inclusive national TB plans, and calls for action across all three pillars of the End TB Strategy for migrant-sensitive care and prevention, bold intersectoral policies and systems supportive of migrants, and operational research. More research is needed on the TB burden and challenges faced by migrants and on the feasibility and effectiveness of approaches proposed here and the scaling up of models already underway. Political commitment at the highest national and international levels will be critical to intensify action for promoting the health of migrants on the road to achieving the end TB targets.
全球有近10亿移民，移民是当今世界面临的一个动态且具有分歧性的现象。移民群体具有多样性，移民过程中的各种状况往往会对移民的身心健康和社会福祉构成风险，某些亚群体比其他群体更易受到伤害。健康和结核病的若干决定因素相互作用，增加了移民感染结核、患结核病以及治疗效果不佳的易感性，使他们成为结核病的重点人群。本文是《国际结核病和肺部疾病杂志》关于结核病与移民的最新技术系列文章的第一篇。它概述了移民趋势、移民途径和社会决定因素以及对结核病的影响。本文概述了一个预防和减轻移民结核病负担的框架，该框架改编自世界卫生组织的《终止结核病战略》，并符合终止结核病伙伴关系的全球计划和可持续发展目标议程。该框架强调需要制定包含移民的国家结核病计划，并呼吁在《终止结核病战略》的所有三个支柱方面采取行动，即提供对移民敏感的护理和预防、大胆的跨部门政策以及支持移民的系统，开展业务研究。还需要就移民面临的结核病负担和挑战以及此处提出的方法的可行性和有效性以及扩大现有模式开展更多研究以及扩大现有模式。国家和国际最高层面的政治承诺对于加强行动以促进移民健康从而实现终止结核病目标至关重要。
