P111

1:EPIUnit ITR, Instituto de Saúde Pública da Universidade do Porto, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; 2:Estudos das Populações - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; 3:Barcelos/Esposende Local Health Unit, Public Health Unit Barcelos/Esposende, Portugal; 4:Departamento de Ciências Químicas, Faculdade Farmácia, Universidade do Porto, Porto, Portugal; 5:UMCG dept of pulmonary diseases and tuberculosis, University of Groningen, The Netherlands; 6:University of Groningen, University Medical Center, TB center Beatrixoord, Haren, The Netherlands; 7:Head of National TB Reference Laboratory, Hamad Medical Corporation, Qatar; 8:Sydney Institute for Infectious Diseases (Sydney ID), The University of Sydney, Sydney, Australia; 9:School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; 10:Westmead Hospital, Sydney, Australia; 11:Institute of microbiology and immunology, Faculty of Medicine, University of Belgrade, Serbia; 12:Pulmonology Department, Centro Hospitalar e Universitário do Algarve, Faro, Portugal; 13:Centre for Multidisciplinary Research in Health Science (MACH), Università' di Milano, Milan, Italy; 14:Municipal institute for lung disease and TB, Belgrade, Serbia; 15:Centro de Investigação em Saúde de Manhiça, Maputo Mozambique & ISGlobal (Hospital Clínic - Universitat de Barcelona, Barcelona) & Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain; 16:Department of Pulmonology, Allergology and Clinical Immunology, National Institute for Infectious Diseases L. Spallanzani-IRCCS, Italy; 17:Inselspital, Bern University Hosptital, University of Bern, Bern, Switzerland; 18:Marius Nasta Institute of Pneumophtiziology in Bucharest, Romania; 19:Zambia National Public Health Institute, Zambia; 20:Clinical Infectious Diseases, Research Center Borstel, Leibniz Lung Center, Borstel, Germany; 21:Respiratory Medicine and International Health, University of Lübeck, Germany; 22:Baylor College of Medicine and Texas Children's Hospital, Global TB Program, Houston, TX, USA; 23:Clinical Tuberculosis Unit, German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems, Germany; 24:Royal Free Hospital & University College London, England; 25:University of Zagreb School of Medicine, Croatia; University Hospital Centre Zagreb, Croatia; 26:Sydney Institute for Infectious Diseases (Sydney ID) and the WHO Collaborating Centre in Tuberculosis, The University of Sydney, Sydney, Australia; 27:Northern State Medical University, Arkhangelsk, Russia; 28:Department of Pulmonary Diseases, Radboud University Medical Center-Dekkerswald, Nijmegen, The Netherlands; 29:Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy; 30:Unidad de Salud Internacional Vall d’Hebron-Drassanes, Servicio de Infecciosas, Hospital Universitario Vall d’Hebron, PROSICS Barcelona, Barcelona, Spain; 31:Universidad Autónoma de Barcelona, Medicine department, Barcelona. España; 32:Grupo de Estudio de Infecciones por Micobacterias (GEIM) de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain; 33:Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid. España; 34:Faculty of Medical Sciences, Goce Delcev University, Stip, Republic of North Macedonia; 35:Institute for Lung Diseases and Tuberculosis, Skopje, Republic of North Macedonia; 36:Hospital Muñiz, Universidad de Buenos Aires, Argentina; 37:Landeshauptstadt Stuttgart, Public Health Department, Germany; 38:Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; 39:Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine 4 - Pneumology, Kepler University Hospital, Linz, Austria; 40:Medical Faculty, Johannes Kepler University Linz, Linz, Austria; 41:Ignaz-Semmelweis-Institute, Interuniversity Institute for Infection Research, Vienna, Austria; 42:Hamburg Tuberculosis Control Unit, District Public Health Department Hamburg-Mitte, Hamburg, Germany; 43:KNCV Tuberculosis Foundation, The Hague, The Netherlands; 44:Division of Infectious Diseases, Oregon Health and Science University, Portland, Oregon, USA; 45:Hinduja Hospital & Research Centre, Mumbai, India; 46:Filha ry, Helsinki and University of Turku, Turku, Finland; 47:Experimental Tuberculosis Unit. Microbiology Department. Germans Trias i Pujol Research Institute (IGTP) and Hospital (HUGTIP), Badalona, Catalonia, Spain; 48:CIBER Enfermedades Respiratorias, Madrid, Spain; 49:Universitat Autònoma de Barcdelona, Bellaterra, Catalonia, Spain; 50:Centro de Saúde Pública Doutor Gonçalves Ferreira – Instituto de Saúde Pública Doutor Ricardo Jorge, INSA Porto, Porto, Portugal

Background
The disproportionate burden of tuberculosis (TB) among migrants in the WHO European Region highlights the urgent need to address the public health challenges linked to global migration. Current screening procedures and recommendations for active TB and TB infection (TBI) vary widely across European countries, underscoring the necessity for standardized practices and coordinated responses.

Methods
This study utilized the Delphi method to convene a multidisciplinary panel of 33 TB experts from academia, healthcare, non-governmental organizations, and government agencies across 22 European countries. The goal was to develop consensus-based recommendations to harmonize migrant TB screening practices across the region.

Results
The panel formulated 19 consensus statements and 36 actionable recommendations directed at governments, health systems, and other relevant stakeholders. These recommendations span four key domains: (1) policy; (2) health systems and health professionals; (3) screening procedures and target populations; and (4) treatment and continued care. Notably, 7 statements and 19 recommendations were unanimously supported, while 8 recommendations had more than 10% disagreement.

Discussion
The study provides the first harmonized guidance for TB screening among migrants in Europe. Key recommendations emphasize the need for culturally inclusive, evidence-based, and feasible approaches that balance immediate health system improvements with long-term public health goals. These consensus outcomes offer a framework for addressing current inconsistencies and advancing the elimination of TB as a public health threat across the European Region.