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Immigration and tuberculosis evolution in Catalonia central region. 10 years (1996–2005)

Abstract number: P1554

Pina J., Ferrer A., Sala R.M.

Introduction: Immigrants from countries with a high tuberculosis (TB) prevalence may affect tuberculosis control in low incidence countries because there is a gradient of risk of disease among populations. The foreign-born, have emerged as the largest single component of the burden of tuberculosis in most industrialised countries.

Methods: Two periods cohort study: from 1996 to 2000 and from 2001 to 2005.TB notified cases from Catalonia Central Region-CCR-(6577 km2 and 1528144 inhabitants) has been included.

Proportion of immigrants – foreign-born arrived to CCR – were obtained. Indicators of TB control performance as proportion of tuberculosis cases with unsuccesful treatment outcome (UTO) and proportion of contact tracing (CT) within sputum smear positive patients(AFB+) were estimated as follows:

UTO: defaults, plus treatment failures, plus transfers/total patients with pulmonary tuberculosis. Goal <10% (IUATLD/WHO)

CT in AFB+ goal: over 85%.

Overall and spanish population TB incidence per 100.000 inhabitants and its average annual decline (AAD) were calculated.

Results: Immigrants proportion increased from 1.2% in 1996 to 1.5% in 2000 and from 2.9% in 2001 to 8.5% in 2005. 95% foreign-borns came from countries with 50–99 TB cases /100,000 hab.

1996–2000 period:

1530 new TB cases were notified (6% of whom were immigrants).

UTO: 8.8% in spanish vs 23.2% in immigrants (p < 0001).

CT: 88.5% in spanish vs 40.5% in immigrants (p < 0001).

Overall TB incidence: 28.3 in 1996 and 18.9 in 2000, AAD 9.6%.

Spanish population incidence rates decreased from 27.5 in 1996 to 16.7 in 2000; 11.2% AAD.

2001–2005 period:

1352 new TB cases were notified (immigrants, 21.8%).

UTO: 7.6% spanish vs 28.9% immigrants (p < 0001).

CT: 91% spanish vs 62.2% immigrants (p < 0001).

Overall TB incidence decreased from 20.8 in 2001 to 18.4 in 2005, 3% AAD.

Spanish population incidence rates decreased from 18.8 in 2001 to 14.8 in 2005; 5.8% AAD.

Conclusions: Immigrant population shows poorly tuberculosis control performance results (UTO > 10% and low proportion of contact tracing).

Notification data indicate that the decline has slowed down after first period despite spanish population tuberculosis control measures has been effective (UTO < 10%). As TB incidence decrise in spanish, increase the proportion of immigrants among tuberculosis cases.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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