Photo: KNCV Ethiopia
A systematic review conducted by the MENA Migrant Health project and published in Travel Medicine and Infectious Disease shows that migrants in the Middle East and North Africa (MENA) experience significantly higher rates of tuberculosis (TB) compared to non-migrants, alongside lower treatment success and greater vulnerability to drug-resistant forms of the disease.
The review analysed 57 studies across 12 MENA countries, including data from over 95,000 TB cases and more than 3.5 million migrants. TB incidence among migrants ranged from 26.7 to 69.8 per 100,000, compared to 11.5 to 16.8 per 100,000 in non-migrants. Although TB-related mortality was around 20% lower in migrants, treatment success rates remained below the 90% threshold recommended by the World Health Organisation (WHO).
The study also found that drug-resistant TB was more common among migrants. However, definitions of “migrant” varied widely, and most studies failed to distinguish between legal status or country of origin, highlighting the need for harmonised data collection across the region.
“Without targeted strategies and better surveillance—especially from underrepresented areas like North Africa—current TB elimination efforts risk leaving migrant populations behind,” said Taha Maatoug, PhD student of the MENA Migrant Health project and first author of the study.
Researchers identified three major evidence gaps: scarce data from North African countries, a reliance on absolute case counts rather than incidence or prevalence rates, and frequent use of citizenship instead of migration status to classify individuals. These limitations constrain the ability of public health programmes to deliver tailored, effective TB responses for migrant populations.
The authors also emphasise the role of structural barriers, such as lack of access to care, fear of deportation, and restrictive policies, in reducing treatment adherence and exacerbating TB risk among migrants. These findings reinforce the need for cross-border coordination, inclusive health policies, and mobile outreach services to improve early detection, ensure continuity of care, and close the persistent equity gaps in TB outcomes.
Reference
Maatoug, T., Seedat, F., Elafef, E. et al. Burden, clinical outcomes, and characteristics of tuberculosis in migrant populations in the middle East and North African region: A systematic review and meta-analyses. Travel Medicine and Infectious Disease. July-August 2025. https://doi.org/10.1016/j.tmaid.2025.102872
