Photo: USAID West Africa / Wikimedia Commons (Public domain)
The link between irregular migration and tuberculosis is well-recognised but poorly quantified. A new multi-country study has changed that, documenting for the first time the scale of the disparity — and identifying the specific mechanisms that drive it.
- 4× higher TB burden in irregular vs regular migrants
- 28,341 cases, 14 countries, 2018–2024
- 67% of migrants on TB treatment had a gap of >30 days in transit
- Treatment success: 71% (irregular) vs 83% (regular)
The study, spanning Europe, North Africa and the Middle East, analysed 28,341 TB cases diagnosed between 2018 and 2024 across 14 countries. Researchers categorised each case by documented entry status and compared TB burden, diagnostic delay and treatment outcomes between regular and irregular migrants, adjusting for country of origin and socioeconomic status.
The headline finding is stark: after adjustment, migrants who entered through irregular routes had a TB burden approximately four times higher than those who entered through documented, regular channels. The disparity was consistent across all 14 country settings and all origin regions.
Three mechanisms explain the gap. First, prolonged time in transit — irregular routes typically involve weeks or months in crowded, poorly ventilated settings that are ideal for airborne transmission. Second, treatment interruption: of the migrants in the study who were already on TB treatment at the time of their journey, 67 per cent had a gap in treatment of more than 30 days during transit. Third, delayed diagnosis at destination: fear of immigration enforcement, documentation requirements at health facilities, and lack of knowledge of entitlements mean that symptomatic migrants delay presenting for care — sometimes for months.
Treatment success rates tell the same story. For irregular migrants, the success rate was 71 per cent — compared with 83 per cent for regularly-documented migrants in the same study settings. The gap is not primarily clinical; it reflects disrupted care continuity during secondary movements and return journeys.
The authors call for unconditional care guarantees: TB screening and treatment must be fully decoupled from immigration enforcement. They also recommend extending directly observed therapy programmes to informal accommodation, migrant worker housing and transit facilities. For Eastern Europe and the Caucasus — where TB rates are among the highest in the WHO European Region — these findings demand immediate policy attention.
Source: European Respiratory Journal / multi-country study consortium, August 2026.
Professor, David Tvildiani Medical University | Chair, Public Health Institute of Georgia | Founder, Accréditation Sans Frontières
