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Community-based testing of migrants for infectious diseases (COMBAT-ID) : impact, acceptability and cost-effectiveness of identifying infectious diseases among migrants in primary care : protocol for an interrupted time-series, qualitative and health economic analysis

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Pareek, Manish, Eborall, Helen C, Wobi, Fatimah, Ellis, Kate S, Kontopantelis, Evangelos, Zhang, Fang, Baggaley, Rebecca, Hollingsworth, T Deirdre, Baines, Darrin, Patel, Hemu, Haldar, Pranabashis, Patel, Mayur, Stephenson, Iain, Browne, Ivan, Gill, Paramjit, Kapur, Rajesh, Farooqi, Azhar, Abubakar, Ibrahim and Griffiths, Chris (2019) Community-based testing of migrants for infectious diseases (COMBAT-ID) : impact, acceptability and cost-effectiveness of identifying infectious diseases among migrants in primary care : protocol for an interrupted time-series, qualitative and health economic analysis. BMJ Open, 9 (3). e029188. doi:10.1136/bmjopen-2019-029188 ISSN 2044-6055.

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Official URL: http://dx.doi.org/10.1136/bmjopen-2019-029188

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Abstract

Background: Migration is a major global driver of population change. Certain migrants may be at increased risk of infectious diseases, including tuberculosis (TB), HIV, hepatitis B and hepatitis C, and have poorer outcomes. Early diagnosis and management of these infections can reduce morbidity, mortality and onward transmission and is supported by national guidelines. To date, screening initiatives have been sporadic and focused on individual diseases; systematic routine testing of migrant groups for multiple infections is rarely undertaken and its impact is unknown. We describe the protocol for the evaluation of acceptability, effectiveness and cost-effectiveness of an integrated approach to screening migrants for a range of infectious diseases in primary care.

Methods and analysis: We will conduct a mixed-methods study which includes an observational cohort with interrupted time-series analysis before and after the introduction of routine screening of migrants for infectious diseases (latent TB, HIV, hepatitis B and hepatitis C) when first registering with primary care within Leicester, UK. We will assess trends in the monthly number and rate of testing and diagnosis for latent TB, HIV, hepatitis B and hepatitis C to determine the effect of the policy change using segmented regression analyses at monthly time-points. Concurrently, we will undertake an integrated qualitative sub-study to understand the views of migrants and healthcare professionals to the new testing policy in primary care. Finally, we will evaluate the cost-effectiveness of combined infection testing for migrants in primary care.

Ethics and dissemination: The study has received HRA and NHS approvals for both the interrupted time-series analysis (16/SC/0127) and the qualitative sub-study (16/EM/0159). For the interrupted time-series analysis we will only use fully anonymised data. For the qualitative sub-study, we will gain written, informed, consent. Dissemination of the results will be through local and national meetings/conferences as well as publications in peer-reviewed journals.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Immigrants -- Health and hygiene -- Research, Communicable diseases , Emigration and immigration -- Health aspects, Medical policy, Transcultural medical care
Journal or Publication Title: BMJ Open
Publisher: BMJ
ISSN: 2044-6055
Official Date: 2019
Dates:
DateEvent
2019Published
7 March 2019Available
28 January 2019Accepted
Volume: 9
Number: 3
Article Number: e029188
DOI: 10.1136/bmjopen-2019-029188
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 12 March 2019
Date of first compliant Open Access: 15 March 2019
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIED[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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