Shaping a Community-based Pathway to Improve TB Surveillance Among African and Hindustan Immigrants Experiencing Vulnerabilities

This two-phase, mixed-methods approach project aims to develop a community-based, participatory, and co-created TB/TB infection (TBI) screening care pathway for African and Hindustan immigrants, who often face socioeconomic vulnerabilities and barriers to healthcare access, including TB/TBI screening. The first phase involves the co-design of a TB/TBI screening care pathway through four thematic workshops using the Double-Diamond theoretical framework. These workshops will engage key stakeholders, including immigrants, community leaders, healthcare professionals, and academics, to identify barriers, define needs, and develop actionable measures to improve TB/TBI screening care. The second phase involves a community-based study to implement the care pathway and estimate the incidence of TB and TBI among 200 immigrants from Angola, Cabo Verde, Guinea-Bissau, Mozambique, India, Bangladesh, and Nepal. Participants will be recruited through Grupcommunity services, and data will be collected on demographic, socioeconomic, health, and migration-related factors. The screening pathway will be implemented and evaluated, with patient-related outcomes measured to assess its effectiveness. The primary outcomes include the development of a culturally sensitive TB/TBI screening care pathway and the estimation of TB and TBI incidence among high-risk immigrant populations. Secondary outcomes include the profiling of immigrant populations, the identification of social vulnerabilities, and the establishment of eligibility criteria for TB/TBI screening in similar populations. We expected to advance knowledge on the specific needs of vulnerable immigrants regarding TB/TBI screening and care and to empower communities, improve access to healthcare, and inform policymakers on tailored prevention and control strategies. The findings will contribute to the global effort to eliminate TB by addressing the unique challenges faced by immigrant populations in low-incidence countries like Portugal.

Inclusion Criteria: \- adult immigrants, aged 18 years or older, from Angola, Cape Verde, Guinea-Bissau, Mozambique, India, Bangladesh, or Nepal, who began their migration journey less than five years ago, who attend or are identified through community services or associated community networks, and who agree to participate by signing an informed consent form. Exclusion Criteria: * Participants with a legally appointed representative * Participants incapable of understanding essential study information, even with linguistic or cultural mediation support and with any clinical condition that prevents the interview, informed consent, or screening process