OBJECTIVE: To perform a comparative analysis of tuberculous immigrants and native-born subjects at a tertiary centre in Madrid, Spain, from January 1990 to December 2002. RESULTS: The annual incidence of tuberculosis (TB) decreased from 141 in 1990 to 73 in 2002 despite an increase among immigrants (from 1% in 1990 to 27% in 2002), with 98 cases of TB among 1353 immigrants (overall rate 7.2%). The mean age was 30 years (6-77) and 54% were male. Most patients were from Latin America (55%) and Africa (37%). TB was diagnosed within 2 years of arrival in 69%. When performed, purified protein derivative test was positive in 88%. Human immunodeficiency virus co-infection was present in 6% vs. 37% among the native-born (P < 0.001). Pulmonary TB was the most frequent form in both groups (79% and 80%), with no differences in rates of sputum positivity (70% vs. 75%). Primary drug resistance was significantly higher among immigrants (13% vs. <6% among the native-born, P < 0.05). Initial four-drug regimens were followed by all immigrants. Overall, 82% of the patients were cured, one died due to disseminated disease (1%), and follow-up data were incomplete in 17 (17%). CONCLUSION: TB among immigrants was clinically similar, but was not related to the common risk factors observed in native-born subjects. Given the higher prevalence of primary resistance in this population, initial four-drug regimens should be prescribed until susceptibility results are available.
OBJECTIVE: To perform a comparative analysis of tuberculous immigrants and native-born subjects at a tertiary centre in Madrid, Spain, from January 1990 to December 2002. RESULTS: The annual incidence of tuberculosis (TB) decreased from 141 in 1990 to 73 in 2002 despite an increase among immigrants (from 1% in 1990 to 27% in 2002), with 98 cases of TB among 1353 immigrants (overall rate 7.2%). The mean age was 30 years (6-77) and 54% were male. Most patients were from Latin America (55%) and Africa (37%). TB was diagnosed within 2 years of arrival in 69%. When performed, purified protein derivative test was positive in 88%. Human immunodeficiency virus co-infection was present in 6% vs. 37% among the native-born (P < 0.001). Pulmonary TB was the most frequent form in both groups (79% and 80%), with no differences in rates of sputum positivity (70% vs. 75%). Primary drug resistance was significantly higher among immigrants (13% vs. <6% among the native-born, P < 0.05). Initial four-drug regimens were followed by all immigrants. Overall, 82% of the patients were cured, one died due to disseminated disease (1%), and follow-up data were incomplete in 17 (17%). CONCLUSION: TB among immigrants was clinically similar, but was not related to the common risk factors observed in native-born subjects. Given the higher prevalence of primary resistance in this population, initial four-drug regimens should be prescribed until susceptibility results are available.
Authors: Cristina Bocanegra; Fernando Salvador; Elena Sulleiro; Adrián Sánchez-Montalvá; Albert Pahissa; Israel Molina Journal: Am J Trop Med Hyg Date: 2014-10-20 Impact factor: 2.345
Authors: Gonzalo G Alvarez; Brian Gushulak; Khaled Abu Rumman; Ekkehardt Altpeter; Daniel Chemtob; Paul Douglas; Connie Erkens; Peter Helbling; Ingrid Hamilton; Jane Jones; Alberto Matteelli; Marie-Claire Paty; Drew L Posey; Daniel Sagebiel; Erika Slump; Anders Tegnell; Elena Rodríguez Valín; Brita Askeland Winje; Edward Ellis Journal: BMC Infect Dis Date: 2011-01-04 Impact factor: 3.090
Authors: Anna Odone; Matteo Riccò; Matteo Morandi; Bianca M Borrini; Cesira Pasquarella; Carlo Signorelli Journal: BMC Public Health Date: 2011-05-23 Impact factor: 3.295
Authors: Ana Maria Tavares; Inês Fronteira; Isabel Couto; Diana Machado; Miguel Viveiros; Ana B Abecasis; Sónia Dias Journal: PLoS One Date: 2017-09-28 Impact factor: 3.240