Burden, clinical outcomes, and characteristics of tuberculosis in migrant populations in the middle East and North African region: A systematic review and meta-analyses
Introduction: Migrants in the Middle East and North Africa (MENA) region face an increased tuberculosis (TB) risk due to socioeconomic and structural barriers. This systematic review synthesises evidence on TB burden, clinical outcomes, and epidemiological characteristics among migrants in MENA. Met...
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Elsevier
2025-07-01
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| Series: | Travel Medicine and Infectious Disease |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S147789392500078X |
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| author | Taha Maatoug Farah Seedat Eman Elafef Anissa Ouahchi Ali Mtiraoui Stella Evangelidou Wejdene Mansour Ana Requena-Méndez Dominik Zenner |
| author_facet | Taha Maatoug Farah Seedat Eman Elafef Anissa Ouahchi Ali Mtiraoui Stella Evangelidou Wejdene Mansour Ana Requena-Méndez Dominik Zenner |
| author_sort | Taha Maatoug |
| collection | DOAJ |
| description | Introduction: Migrants in the Middle East and North Africa (MENA) region face an increased tuberculosis (TB) risk due to socioeconomic and structural barriers. This systematic review synthesises evidence on TB burden, clinical outcomes, and epidemiological characteristics among migrants in MENA. Methods: We searched six electronic databases and grey literature sources for studies published between 2000 and September 2024 in any language. Eligible studies reported primary data on TB prevalence, incidence, treatment outcomes, and clinical or epidemiological features in migrants. Pooled estimates were calculated using DerSimonian & Laird's random-effects model where applicable or narratively synthesised. Results: Of the 779 records identified, we included 57 studies, comprising 95,190 TB cases and 3,532,359 migrants across 12 MENA countries. TB incidence was consistently higher in migrants than non-migrants (26.7–69.8/100,000 vs. 11.5–16.8/100,000). Migrants had lower TB-related mortality (pooled OR 0.8, 95 % CI 0.7–0.9; I2 = 2.9 %), however, treatment success rates were consistently below the WHO-recommended 90 % threshold. Migrant TB patients were younger (mean age difference: 12.8 years; 95 % CI 8.8–16.0; I2 = 86.5 %) and predominantly male (sex ratio: 1:5). Drug-resistant TB was more common among migrants, though this was not always statistically significant (multi-drug-resistant TB: pooled OR 1.2; 95 % CI 0.9–1.6; I2 = 40.2 %), while extrapulmonary TB was more prevalent among non-migrants (33.4–83.4 % vs. 16.6–72.9 %). Conclusion: Migrants in MENA region experience disproportionate TB burden and poorer treatment outcomes, underscoring the need for targeted interventions. Enhanced data, especially from North Africa, is essential to support regional TB elimination aligned with World Health Organization and Sustainable Development Goals. |
| format | Article |
| id | doaj-art-3022606c99f74ec2955782f29d5e53dc |
| institution | DOAJ |
| issn | 1873-0442 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Travel Medicine and Infectious Disease |
| spelling | doaj-art-3022606c99f74ec2955782f29d5e53dc2025-08-20T02:39:21ZengElsevierTravel Medicine and Infectious Disease1873-04422025-07-016610287210.1016/j.tmaid.2025.102872Burden, clinical outcomes, and characteristics of tuberculosis in migrant populations in the middle East and North African region: A systematic review and meta-analysesTaha Maatoug0Farah Seedat1Eman Elafef2Anissa Ouahchi3Ali Mtiraoui4Stella Evangelidou5Wejdene Mansour6Ana Requena-Méndez7Dominik Zenner8University of Sousse, Faculty of Medicine of Sousse, Research Laboratory Quality of Care and Management of Maternal Health Services, LR12ES03, Sousse, Tunisia; Barcelona Institute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, SpainCity St George's University of London, London, United KingdomBarcelona Institute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, Spain; Blue Nile National Institute for Communicable Diseases, University of Gezira, SudanUniversity of Sousse, Faculty of Medicine of Sousse, Research Laboratory Quality of Care and Management of Maternal Health Services, LR12ES03, Sousse, Tunisia; Barcelona Institute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, SpainUniversity of Sousse, Faculty of Medicine of Sousse, Research Laboratory Quality of Care and Management of Maternal Health Services, LR12ES03, Sousse, TunisiaBarcelona Institute for Global Health (ISGlobal), University of Barcelona, Barcelona, SpainUniversity of Sousse, Faculty of Medicine of Sousse, Research Laboratory '' Metabolic Biophysics and Applied Pharmacology'' LR12ES02, TunisiaBarcelona Institute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain; Corresponding author. Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.Queen Mary University London, London, United KingdomIntroduction: Migrants in the Middle East and North Africa (MENA) region face an increased tuberculosis (TB) risk due to socioeconomic and structural barriers. This systematic review synthesises evidence on TB burden, clinical outcomes, and epidemiological characteristics among migrants in MENA. Methods: We searched six electronic databases and grey literature sources for studies published between 2000 and September 2024 in any language. Eligible studies reported primary data on TB prevalence, incidence, treatment outcomes, and clinical or epidemiological features in migrants. Pooled estimates were calculated using DerSimonian & Laird's random-effects model where applicable or narratively synthesised. Results: Of the 779 records identified, we included 57 studies, comprising 95,190 TB cases and 3,532,359 migrants across 12 MENA countries. TB incidence was consistently higher in migrants than non-migrants (26.7–69.8/100,000 vs. 11.5–16.8/100,000). Migrants had lower TB-related mortality (pooled OR 0.8, 95 % CI 0.7–0.9; I2 = 2.9 %), however, treatment success rates were consistently below the WHO-recommended 90 % threshold. Migrant TB patients were younger (mean age difference: 12.8 years; 95 % CI 8.8–16.0; I2 = 86.5 %) and predominantly male (sex ratio: 1:5). Drug-resistant TB was more common among migrants, though this was not always statistically significant (multi-drug-resistant TB: pooled OR 1.2; 95 % CI 0.9–1.6; I2 = 40.2 %), while extrapulmonary TB was more prevalent among non-migrants (33.4–83.4 % vs. 16.6–72.9 %). Conclusion: Migrants in MENA region experience disproportionate TB burden and poorer treatment outcomes, underscoring the need for targeted interventions. Enhanced data, especially from North Africa, is essential to support regional TB elimination aligned with World Health Organization and Sustainable Development Goals.http://www.sciencedirect.com/science/article/pii/S147789392500078XTuberculosisMigrantMENA regionSystematic reviewMeta-analysis |
| spellingShingle | Taha Maatoug Farah Seedat Eman Elafef Anissa Ouahchi Ali Mtiraoui Stella Evangelidou Wejdene Mansour Ana Requena-Méndez Dominik Zenner Burden, clinical outcomes, and characteristics of tuberculosis in migrant populations in the middle East and North African region: A systematic review and meta-analyses Travel Medicine and Infectious Disease Tuberculosis Migrant MENA region Systematic review Meta-analysis |
| title | Burden, clinical outcomes, and characteristics of tuberculosis in migrant populations in the middle East and North African region: A systematic review and meta-analyses |
| title_full | Burden, clinical outcomes, and characteristics of tuberculosis in migrant populations in the middle East and North African region: A systematic review and meta-analyses |
| title_fullStr | Burden, clinical outcomes, and characteristics of tuberculosis in migrant populations in the middle East and North African region: A systematic review and meta-analyses |
| title_full_unstemmed | Burden, clinical outcomes, and characteristics of tuberculosis in migrant populations in the middle East and North African region: A systematic review and meta-analyses |
| title_short | Burden, clinical outcomes, and characteristics of tuberculosis in migrant populations in the middle East and North African region: A systematic review and meta-analyses |
| title_sort | burden clinical outcomes and characteristics of tuberculosis in migrant populations in the middle east and north african region a systematic review and meta analyses |
| topic | Tuberculosis Migrant MENA region Systematic review Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S147789392500078X |
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