Global Tuberculosis Programme, World Health Organization (WHO), Geneva, Switzerland, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, USA.
Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Int J Tuberc Lung Dis. 2018 Aug 1;22(8):835-843. doi: 10.5588/ijtld.17.0503.
Pillar 3 of the End TB Strategy calls for the promotion of research and innovation at the country level to facilitate improved implementation of existing and novel interventions to end tuberculosis (TB). In an era of increasing cross-border migration, there is a specific need to integrate migration-related issues into national TB research agendas. The objective of the present review is to provide a conceptual framework to guide countries in the development and operationalization of a migrant-inclusive TB research agenda.
We conducted a literature review, complemented by expert opinion and the previous articles in this State of the Art series, to identify important themes central to migration-related TB. We categorized these themes into a framework for a migration-inclusive global TB research agenda across a comprehensive spectrum of research. We developed this conceptual framework taking into account: 1) the biomedical, social and structural determinants of TB; 2) the epidemiologic impact of the migration pathway; and 3) the feasibility of various types of research based on a country's capacity.
The conceptual framework presented here is based on the key principle that migrants are not inherently different from other populations in terms of susceptibility to known TB determinants, but that they often have exacerbated or additional risks related to their country of origin and the migration process, which must be accounted for in developing comprehensive TB prevention and care strategies. A migrant-inclusive research agenda should systematically consider this wider context to have the highest impact.
《终结结核病策略》第三支柱呼吁在国家一级促进研究和创新，以促进现有和新干预措施的实施，从而终结结核病（TB）。在跨境移民不断增加的时代，需要将与移民相关的问题纳入国家结核病研究议程。本综述的目的是提供一个概念框架，指导各国制定和实施包含移民问题的结核病研究议程。
我们进行了文献综述，辅之以专家意见和本专题系列的先前文章，以确定与移民相关的结核病的重要主题。我们将这些主题归入一个涵盖全面研究范围的包含移民问题的全球结核病研究议程框架。我们在制定这个概念框架时考虑到：1）TB 的生物医学、社会和结构性决定因素；2）移民途径对流行病学的影响；以及 3）根据一个国家的能力，各种类型的研究的可行性。
本文提出的概念框架基于一个关键原则，即移民在易感染已知 TB 决定因素方面与其他人群并无本质区别，但他们往往与原籍国和移民过程有关的风险加剧或增加，在制定全面的结核病预防和护理策略时必须考虑到这些风险。一个包含移民问题的研究议程应系统地考虑这一更广泛的背景，以产生最大的影响。
