Abarca Tomás, BrunoPell, ChristopherBueno Cavanillas, AuroraGuillén Solvas, JoséPool, RobertRoura, María2015-10-142015-10-142013-12Abarca Tomás B, Pell C, Bueno Cavanillas A, Guillén Solvas J, Pool R, Roura M. Tuberculosis in migrant populations. A systematic review of the qualitative literature. PLoS ONE. 2013; 8(12):e82440http://hdl.handle.net/10668/2015Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review;BACKGROUND The re-emergence of tuberculosis (TB) in low-incidence countries and its disproportionate burden on immigrants is a public health concern posing specific social and ethical challenges. This review explores perceptions, knowledge, attitudes and treatment adherence behaviour relating to TB and their social implications as reported in the qualitative literature. METHODS Systematic review in four electronic databases. Findings from thirty selected studies extracted, tabulated, compared and synthesized. FINDINGS TB was attributed to many non-exclusive causes including air-born transmission of bacteria, genetics, malnutrition, excessive work, irresponsible lifestyles, casual contact with infected persons or objects; and exposure to low temperatures, dirt, stress and witchcraft. Perceived as curable but potentially lethal and highly contagious, there was confusion around a condition surrounded by fears. A range of economic, legislative, cultural, social and health system barriers could delay treatment seeking. Fears of deportation and having contacts traced could prevent individuals from seeking medical assistance. Once on treatment, family support and "the personal touch" of health providers emerged as key factors facilitating adherence. The concept of latent infection was difficult to comprehend and while TB screening was often seen as a socially responsible act, it could be perceived as discriminatory. Immigration and the infectiousness of TB mutually reinforced each another exacerbating stigma. This was further aggravated by indirect costs such as losing a job, being evicted by a landlord or not being able to attend school. CONCLUSIONS Understanding immigrants' views of TB and the obstacles that they face when accessing the health system and adhering to a treatment programme-taking into consideration their previous experiences at countries of origin as well as the social, economic and legislative context in which they live at host countries- has an important role and should be considered in the design, evaluation and adaptation of programmes.enAceptación de la atención de saludMigrantesEmigrantes e inmigrantesConocimientos, actitudes y práctica en saludTuberculosisIncidenciaMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Delivery of Health Care::Attitude to Health::Health Knowledge, Attitudes, PracticeMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Information Science::Information Science::Data Collection::Vital Statistics::Morbidity::IncidenceMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Delivery of Health Care::Attitude to Health::Patient Acceptance of Health CareMedical Subject Headings::Named Groups::Persons::Transients and MigrantsMedical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Tuberculosis, PulmonaryMedical Subject Headings::Named Groups::Persons::Emigrants and Immigrantsreview article24349284open access10.1371/journal.pone.00824401932-6203PMC3857814