Factors associated to preventive tuberculosis treatment accessibility for migrants, refugees and stateless people: a systematic review

• Grant number: 24/23652-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: May 01, 2025
• End date: April 30, 2026
• Field of knowledge: Health Sciences - Nursing - Public Health Nursing
• Principal Investigator: Ricardo Alexandre Arcêncio
• Grantee: Joyce Aparecida Turco Machado Francisco
• Host Institution: Escola de Enfermagem de Ribeirão Preto (EERP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Introduction: Tuberculosis is a public health issue linked to poverty and social exclusion. Migration is a complex process that can harm an individual's health. International migrants, refugees, and stateless persons in Brazil have a higher prevalence of infection compared to the general population, as well as 5.8 times more risk of developing tuberculosis. Despite the World Health Organization's recommendation for preventive treatment for MIRA, not all countries have adopted this preventive strategy. Objective: To analyze the factors associated with accessibility to tuberculosis preventive treatment (TPT) among MIRA and the countries that recommend it. Method: This is a systematic review based on the recommendations of the Joanna Briggs Institute and PRISMA. The PICo strategy was used to create the guiding question: "What factors are associated with accessibility to Tuberculosis Preventive Treatment among International Migrants, Refugees, and Stateless persons?". The databases to be used include Academic Search Premier, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Google Scholar, LILACS, PubMed, Scopus, and Web of Science for the literature search. Observational studies related to TPT among MIRA will be included. The quality and risk of bias will be assessed using the Newcastle-Ottawa scale and GRADE for the different types of studies. The findings will be synthesized according to the accessibility framework by Fekete, and will include graphs and tables. A meta-analysis will be conducted, which will include effect measures, relative risk, odds ratio, and prevalence ratio, if two or more studies reporting effect measures are found. Finally, the estimates will be presented in a Forest plot to facilitate the analysis and conclusion of the results.