Testing for tuberculosis infection and screening for tuberculosis disease among incoming refugees from Ukraine to European countries

Aimed at national policymakers, public health and healthcare planners, staff working in reception centres, and healthcare staff caring for displaced persons, the information note concludes that universal testing of incoming refugees from Ukraine for tuberculosis (TB) infection is not recommended. Specific groups, such as household contacts of bacteriologically confirmed pulmonary cases, or those who are immunocompromised should however be considered for TB infection testing.

In terms of screening for TB disease, universal screening is also not recommended, however, it can be considered for certain groups at risk of TB, such as people living with HIV or who are contacts of TB patients.

Tuberculosis epidemiological situation in Ukraine

Ukraine is considered a TB high priority country in the WHO European Region and is one of nine countries globally with a high burden of multidrug-resistant TB. The estimated TB incidence is 73 per 100 000 population compared to 9.5 per 100 000 in the EU/EEA. In 2020, 19 521 TB cases were notified, 44.6 per 100 000 population. The total number of TB cases in the EU/EEA was 33 148 in the same period.

In 2020, 32.6% of all bacteriologically confirmed pulmonary TB cases in Ukraine were rifampicin-resistant or multidrug-resistant TB (RR/MDR-TB) and 4,117 MDR/RR-TB cases were notified. The total number of RR/MDR-TB cases in the EU/EEA was 595 in 2020. Of note is the male/female ratio in Ukraine of 2.4, thus the largest part of TB cases is diagnosed in men. Also, only a small proportion of RR/MDR-TB is diagnosed in children.