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Journal of Public Health Advance Access published online on July 4, 2006
Journal of Public Health, doi:10.1093/pubmed/fdl031
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© The Author 2006, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Article

Is screening for tuberculosis acceptable to immigrants? A qualitative study

P. Brewin 1, A. Jones 2, M. Kelly 3, M. McDonald 4, E. Beasley 4, P. Sturdy 5, G. Bothamley 1, and C. Griffiths 5 *

1 Department of Respiratory Medicine, Homerton University Hospital, Homerton Row, London E9 6SR, UK
2 Communicable Disease Surveillance Centre, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK
3 Centre for Human Sciences and Medical Ethics, Queen Mary, University of London, London E1 2AT, UK
4 Lower Clapton Health Centre, Hackney, London E5 OPD, UK
5 Centre for Health Sciences, 2 Newark Street, London E1 2AT, UK

* To whom correspondence should be addressed.
C. Griffiths, E-mail: c.j.grifiths{at}qmul.ac.uk


  Abstract

Background Screening of immigrants has been a widespread response to the global resurgence of tuberculosis but has been criticized as discriminatory and stigmatising. Acceptability is an essential but neglected ethical prerequisite of screening programmes, particularly those targeting vulnerable groups such as refugees. No data exist concerning acceptability of tuberculosis screening. We therefore examined the responses of immigrants to screening for tuberculosis in a range of settings.

Methods We carried out a qualitative interview study of a maximum diversity sample of 53 immigrants offered screening for tuberculosis in east London. We recruited people screened in three settings: a social service centre for asylum seekers, a hospital clinic for new entrants and primary care. We confirmed validity of our findings at a focus group of asylum seekers.

Results The opportunity to be screened for tuberculosis was valued highly by recipients. Moreover, many saw being screened as a socially responsible activity. Of the minority raising concerns, few mentioned the possibility of discrimination. Acceptability was high irrespective of setting, with respondents expressing preference for their chosen place of screening.

Conclusion Screening for tuberculosis was highly acceptable to recipients in these settings. Screening should be offered in a range of settings.

Keywords: public health, screening, tuberculosis.
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