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Integrated screening of migrants for multiple infectious diseases: qualitative study of a city-wide programme

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journal contribution
posted on 27.03.2020, 12:26 by Helen Eborall, Fatimah Wobi, Kate Ellis, Janet Willars, Ibrahim Abubakar, Chris Griffiths, Manish Pareek
Background
Migrants from certain regions are at increased risk of key infectious diseases (including HIV, tuberculosis (TB), hepatitis B and hepatitis C). Although guidelines increasingly recommend integrated screening for multiple infections to reduce morbidity little is known about what migrants and healthcare professionals think about this approach.

Methods
Prospective qualitative study in Leicester, United Kingdom within a novel city-wide integrated screening programme in three iterative phases to understand views about infections and integrated screening. Phase 1 focus groups (nine) with migrants from diverse communities (n = 74); phase 2 semi-structured interviews with healthcare professionals involved in the screening pathway (n = 32); phase 3 semi-structured interviews (n = 23) with individuals having tested positive for one/more infections through the programme. Analysis was informed by the constant comparative process and iterative across phases 1–3.

Findings
Migrants’ awareness of TB, HIV and hepatitis B/C varied, with greater awareness of TB and HIV than hepatitis B/C; perceived susceptibility to the infections was low. The integrated screening programme was well-received by migrants and professionals; concerns were limited to data-sharing. As anticipated, given the target group, language was cited as a challenge but mitigated by various interpretation strategies.

Interpretation
This large qualitative analysis is the first to confirm that integrated screening for key infectious diseases is feasible, positively viewed by, and acceptable to, migrants and healthcare professionals. These findings support recent guideline recommendations and therefore have important implications for policy-makers and clinicians as programmes of this type are more widely implemented in diverse settings.

Funding

National Institute for Health Research.

History

Citation

EClinicalMedicine, Volume 21, April 2020, 100315

Author affiliation

Department of Health Sciences; Department of Respiratory Sciences

Version

AM (Accepted Manuscript)

Published in

EClinicalMedicine

Volume

21

Publisher

Elsevier

issn

2589-5370

Acceptance date

27/02/2020

Copyright date

2020

Available date

18/04/2020

Language

en