{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T20:48:56Z","timestamp":1778964536218,"version":"3.51.4"},"reference-count":39,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/501100000659","name":"Research Trainees Coordinating Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,1,28]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-029188","type":"journal-article","created":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T05:43:05Z","timestamp":1552023785000},"page":"e029188","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["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"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1521-9964","authenticated-orcid":false,"given":"Manish","family":"Pareek","sequence":"first","affiliation":[{"name":"Department of Respiratory Sciences, University of Leicester, Leicester, UK"},{"name":"Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen C","family":"Eborall","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Leicester, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatimah","family":"Wobi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Sciences, University of Leicester, Leicester, UK"},{"name":"Department of Health Sciences, University of Leicester, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate S","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6450-5815","authenticated-orcid":false,"given":"Evangelos","family":"Kontopantelis","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK"},{"name":"Centre for Primary Care, NIHR School for Primary Care Research, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Health Care, Wellesley, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Baggaley","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Imperial College London, London, UK"},{"name":"Department of Global Health and Development, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5962-4238","authenticated-orcid":false,"given":"T Deirdre","family":"Hollingsworth","sequence":"additional","affiliation":[{"name":"Big Data Institute, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darrin","family":"Baines","sequence":"additional","affiliation":[{"name":"Department of Accounting , Finance & Economics, Bournemouth University, Poole, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemu","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranabashis","family":"Haldar","sequence":"additional","affiliation":[{"name":"Department of Respiratory Sciences, University of Leicester, Leicester, UK"},{"name":"Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayur","family":"Patel","sequence":"additional","affiliation":[{"name":"NHS Leicester City Clinical Commissioning Group, NHS Leicester City Clinical Commissioning Group, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iain","family":"Stephenson","sequence":"additional","affiliation":[{"name":"Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Browne","sequence":"additional","affiliation":[{"name":"Department of Public Health, Leicester City Council, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paramjit","family":"Gill","sequence":"additional","affiliation":[{"name":"Academic Unit of Primary Care, University of Warwick, Warwick, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajesh","family":"Kapur","sequence":"additional","affiliation":[{"name":"NHS Leicester City Clinical Commissioning Group, NHS Leicester City Clinical Commissioning Group, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azhar","family":"Farooqi","sequence":"additional","affiliation":[{"name":"NHS Leicester City Clinical Commissioning Group, NHS Leicester City Clinical Commissioning Group, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Abubakar","sequence":"additional","affiliation":[{"name":"Institute of Global Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7935-8694","authenticated-orcid":false,"given":"Chris","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Barts Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,3,7]]},"reference":[{"key":"2025121600410518000_9.3.e029188.1","unstructured":"Office for National Statistics. Total International Migration (TIM) tables: 1991- latest. 2012 http:\/\/www.ons.gov.uk\/ons\/publications\/re-reference-tables.html?edition=tcm%3A77-328992 (Accessed 9th Jan 2013)."},{"key":"2025121600410518000_9.3.e029188.2","unstructured":"Office for National Statistics. Estimated population resident in the United Kingdom, by country of birth. 2012 http:\/\/www.statistics.gov.uk\/hub\/population\/population-change\/population-estimates\/index.html (Accessed 9th Jan 2013)."},{"key":"2025121600410518000_9.3.e029188.3","unstructured":"Hardman J . Diversity and migration. Leicester: Leicester City Council, 2012."},{"key":"2025121600410518000_9.3.e029188.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.309.6950.327"},{"key":"2025121600410518000_9.3.e029188.5","unstructured":"Agency HP , Health M . Infectious diseases in non-UK born populations in England, Wales and Northern Ireland. A baseline report -. London: Health Protection Agency Centre for Infections, 2006."},{"key":"2025121600410518000_9.3.e029188.6","unstructured":"Public Health England. Migrant health guide. London: Public Health England, 2012."},{"key":"2025121600410518000_9.3.e029188.7","unstructured":"Gill PS , Kai J , Bhopal RS , et al . Health Care Needs Assessment: Black and Minority Ethnic Groups. In: Raftery J , Stevens A , Mant J , eds. Health care needs assessment: the epidemiologically based needs assessment reviews. Abingdon: Radcliffe Publishing, 2007."},{"key":"2025121600410518000_9.3.e029188.8","unstructured":"Agency HP . Migrant health: infectious diseases in non-UK born populations in the UK. London: Health Protection Agency Centre for Infections, 2011."},{"key":"2025121600410518000_9.3.e029188.9","unstructured":"Public Health England. Tuberculosis case reports and rates by place of birth, UK, 2000-2012. London: Public Health England, 2013. http:\/\/www.hpa.org.uk\/webc\/HPAwebFile\/HPAweb_C\/1317139697553. (Accessed 10th Jan 2013)."},{"key":"2025121600410518000_9.3.e029188.10","unstructured":"Health Protection Agency. Tuberculosis in the UK: annual report on tuberculosis surveillance and control in the UK. London: Health Protection Agency Centre for Infections, 2012."},{"key":"2025121600410518000_9.3.e029188.11","unstructured":"Health Protection Agency. HIV in the United Kingdom: 2012 Report. London: Health Protection Services, 2012."},{"key":"2025121600410518000_9.3.e029188.12","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/cks130"},{"key":"2025121600410518000_9.3.e029188.13","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12070"},{"key":"2025121600410518000_9.3.e029188.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2010.08.002"},{"key":"2025121600410518000_9.3.e029188.15","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.9.2280"},{"key":"2025121600410518000_9.3.e029188.16","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.118133"},{"key":"2025121600410518000_9.3.e029188.17","unstructured":"National Collaborating Centre for Chronic Conditions. Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control. London: Royal College of Physicians, 2011."},{"key":"2025121600410518000_9.3.e029188.18","unstructured":"National Institute for Health and Clinical Excellence. NICE public health guidance 43: Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection. London: NICE, 2012."},{"key":"2025121600410518000_9.3.e029188.19","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70069-X"},{"key":"2025121600410518000_9.3.e029188.20","unstructured":"National Institute for Health and Clinical Excellence. NICE public health guidance 33:Increasing the uptake of HIV testing among black Africans in England. London: NICE, 2011."},{"key":"2025121600410518000_9.3.e029188.21","unstructured":"British HIV Association, British Association of Sexual Health and HIV,. British Infection Society. UK national guidelines for HIV testing. London: BHIVA, 2008."},{"key":"2025121600410518000_9.3.e029188.22","unstructured":"Agency HP . Time to test for HIV: expanded healthcare and community HIV testing in England. London: Health Protection Agency, 2010."},{"key":"2025121600410518000_9.3.e029188.23","unstructured":"Advisory Group on Hepatitis. Case-finding for hepatitis B and C virus infection in minority ethnic populations in the United Kingdom. London: Advisory Group on Hepatitis, 2009."},{"key":"2025121600410518000_9.3.e029188.24","unstructured":"Royal College of General Practitioners. Guidance for the prevention, testing, treatment and management of hepatitis C in primary care. London: Royal College of General Practitioners, 2007."},{"key":"2025121600410518000_9.3.e029188.25","doi-asserted-by":"publisher","DOI":"10.1179\/204777312X13305103762501"},{"key":"2025121600410518000_9.3.e029188.26","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00105810"},{"key":"2025121600410518000_9.3.e029188.27","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-201542"},{"key":"2025121600410518000_9.3.e029188.28","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/S2468-1253(18)30318-2","article-title":"Case finding and therapy for chronic viral hepatitis in primary care (HepFREE): a cluster-randomised controlled trial","volume":"4","author":"Flanagan","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2025121600410518000_9.3.e029188.29","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdl031"},{"key":"2025121600410518000_9.3.e029188.30","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2008.033233"},{"key":"2025121600410518000_9.3.e029188.31","unstructured":"Public Health England and NHS England. Collaborative tuberculosis strategy for England 2015 to 2020. London: Public Health England, 2015."},{"key":"2025121600410518000_9.3.e029188.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2013.08.002"},{"key":"2025121600410518000_9.3.e029188.33","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462303000576"},{"key":"2025121600410518000_9.3.e029188.34","unstructured":"Cochrane Effective Practice and Organisation of Care (EPOC). Interrupted time series (ITS) analyses. EPOC Resources for review authors, 2017. 2017 http:\/\/epoc.cochrane.org\/epoc-specific-resources-review-authors (Accessed 11th Jan)."},{"key":"2025121600410518000_9.3.e029188.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.02.007"},{"key":"2025121600410518000_9.3.e029188.36","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2710.2002.00430.x"},{"key":"2025121600410518000_9.3.e029188.37","doi-asserted-by":"crossref","unstructured":"Charmaz K . Constructing grounded theory: a practical guide through qualitative analysis. London: Sage 2007.","DOI":"10.4135\/9781848607927.n14"},{"key":"2025121600410518000_9.3.e029188.38","unstructured":"National Institute for Health and Clinical Excellence. Guide to the methods of technology appraisal. London: NICE, 2008."},{"key":"2025121600410518000_9.3.e029188.39","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7052.275"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-029188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T08:41:25Z","timestamp":1765874485000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-029188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":39,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,7]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bmjopen-2019-029188"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-029188","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}