New S3 guideline on tuberculosis prevention among recent immigrants published
Just in time for World Tuberculosis Day on March 24, 2026, the new S3 guideline on tuberculosis prevention among newly arrived immigrants has been published online by the AWMF. Commissioned by the German Society for Pneumology and Respiratory Medicine (DGP), it was developed under the leadership of the German Central Committee against (DZK) and the Helmholtz Centre for Infection Research (HZI). Over the past three years, a team of experts from the fields of public health and personalized medicine, as well as people affected by the disease, worked to improve tuberculosis screening—and thus prevention—in Germany. The guideline was funded by the Innovation Fund of the Joint Federal Committee (G-BA).
“The current national tuberculosis control strategy is inadequate,” emphasizes lead author Dr. Brit Häcker, a pulmonologist and medical staff member at the DZK. “That is why, in our S3 guideline, we propose a complete overhaul of the current approach.”
Only those living in group housing are screened for tuberculosis
Häcker and her colleagues point out that, under current law, every immigrant is required to undergo a tuberculosis screening if they are housed in shared accommodation. “However, since no other circumstances are taken into account, this results in many unnecessary screenings in shared accommodations on the one hand, while on the other hand, screening services are lacking for people in other types of housing,” explains the pulmonologist and tuberculosis expert.
The authors write that it is important to take into account the circumstances surrounding newly arrived immigrants.
Offer screening to people from countries with a high incidence of tuberculosis
Accordingly, the new recommendations state: In particular, newly arrived immigrants from countries with a tuberculosis incidence of more than 100 per 100,000 inhabitants should be offered a tuberculosis screening. For people up to age 35, an additional screening for tuberculosis infection (TBI) should be conducted. If an infection is detected, an offer of preventive drug therapy should also be made.
Risk factors such as comorbidities, pre-existing conditions, malnutrition, or difficult refugee circumstances should also be taken into account in order to offer targeted screening to those at highest risk of tuberculosis (TB) infection. “This allows us to use available resources much more efficiently and effectively,” said Brit Häcker.
Improve monitoring strategies, provide services tailored to needs and objectives, and make better use of available resources
Thus, the scientific guideline is aimed not only at physicians but also at policymakers. “With this recommendation, we have established an evidence-based foundation for the prevention and treatment of tuberculosis among immigrants that is unique in Europe,” says Prof. Dr. Berit Lange, the scientific lead of the guideline, with conviction. The head of epidemiology at the HZI and professor of infectious disease epidemiology at Hannover Medical School (MHH) therefore appeals to Berlin: “Use this recommendation, developed by many experts, to prevent not only individual suffering but also the further spread of tuberculosis!”
In the medium term, the strategy outlined in the new S3 guideline even offers Germany the opportunity to become one of the first countries in the world to be TB-free. German policymakers have already committed to this international goal—the EndTB strategy—at high-level United Nations meetings on tuberculosis in 2018 and 2023. “We are showing how it can be done,” say Häcker and Lange on behalf of the entire team of authors. “The expertise is right here!”
