SETTING: The Rotterdam region, the Netherlands, 1995-2006. OBJECTIVE: To identify factors associated with the high tuberculosis (TB) case rate in an urban area. DESIGN: Municipalities were divided into urban and semi-urban/rural municipalities. We compared the characteristics of TB cases and stratified case rates according to age group, immigrant status and place and time of infection between the two areas. RESULTS: The TB case rate in urban municipalities was 3.8-fold higher than in semi-urban/rural municipalities. After stratification for country of birth, the rate ratios were lower (1.7 for immigrants and 2.8 for non-immigrants). Immigrants had most frequently acquired their infection abroad (47% of urban and 62% of semi-urban/rural immigrant cases). In 40% of urban cases and 27% of semi-urban/rural cases, the infection was recently acquired in the Netherlands, translating into a 5.7-fold higher recent transmission case rate for the urban population. CONCLUSIONS: The high urban TB case rate was related to the high proportion of urban immigrants who frequently reactivated an infection acquired abroad. Recent transmission also contributed to a substantial part of the TB caseload in urban municipalities among both urban immigrants and non-immigrants. The authors propose a package of targeted interventions to address the identified factors associated with the high urban TB case rate.
SETTING: The Rotterdam region, the Netherlands, 1995-2006. OBJECTIVE: To identify factors associated with the high tuberculosis (TB) case rate in an urban area. DESIGN: Municipalities were divided into urban and semi-urban/rural municipalities. We compared the characteristics of TB cases and stratified case rates according to age group, immigrant status and place and time of infection between the two areas. RESULTS: The TB case rate in urban municipalities was 3.8-fold higher than in semi-urban/rural municipalities. After stratification for country of birth, the rate ratios were lower (1.7 for immigrants and 2.8 for non-immigrants). Immigrants had most frequently acquired their infection abroad (47% of urban and 62% of semi-urban/rural immigrant cases). In 40% of urban cases and 27% of semi-urban/rural cases, the infection was recently acquired in the Netherlands, translating into a 5.7-fold higher recent transmission case rate for the urban population. CONCLUSIONS: The high urban TB case rate was related to the high proportion of urban immigrants who frequently reactivated an infection acquired abroad. Recent transmission also contributed to a substantial part of the TB caseload in urban municipalities among both urban immigrants and non-immigrants. The authors propose a package of targeted interventions to address the identified factors associated with the high urban TB case rate.
Authors: Knut Lönnroth; Giovanni Battista Migliori; Ibrahim Abubakar; Lia D'Ambrosio; Gerard de Vries; Roland Diel; Paul Douglas; Dennis Falzon; Marc-Andre Gaudreau; Delia Goletti; Edilberto R González Ochoa; Philip LoBue; Alberto Matteelli; Howard Njoo; Ivan Solovic; Alistair Story; Tamara Tayeb; Marieke J van der Werf; Diana Weil; Jean-Pierre Zellweger; Mohamed Abdel Aziz; Mohamed R M Al Lawati; Stefano Aliberti; Wouter Arrazola de Oñate; Draurio Barreira; Vineet Bhatia; Francesco Blasi; Amy Bloom; Judith Bruchfeld; Francesco Castelli; Rosella Centis; Daniel Chemtob; Daniela M Cirillo; Alberto Colorado; Andrei Dadu; Ulf R Dahle; Laura De Paoli; Hannah M Dias; Raquel Duarte; Lanfranco Fattorini; Mina Gaga; Haileyesus Getahun; Philippe Glaziou; Lasha Goguadze; Mirtha Del Granado; Walter Haas; Asko Järvinen; Geun-Yong Kwon; Davide Mosca; Payam Nahid; Nobuyuki Nishikiori; Isabel Noguer; Joan O'Donnell; Analita Pace-Asciak; Maria G Pompa; Gilda G Popescu; Carlos Robalo Cordeiro; Karin Rønning; Morten Ruhwald; Jean-Paul Sculier; Aleksandar Simunović; Alison Smith-Palmer; Giovanni Sotgiu; Giorgia Sulis; Carlos A Torres-Duque; Kazunori Umeki; Mukund Uplekar; Catharina van Weezenbeek; Tuula Vasankari; Robert J Vitillo; Constantia Voniatis; Maryse Wanlin; Mario C Raviglione Journal: Eur Respir J Date: 2015-04 Impact factor: 16.671
Authors: Everton Nunes Silva; Ana Carolina Esteves da Silva Pereira; Wildo Navegantes de Araújo; Flávia Tavares Silva Elias Journal: Rev Panam Salud Publica Date: 2018-03-30
Authors: Phalkun Chheng; Mary Nsereko; LaShaunda L Malone; Brenda Okware; Sarah Zalwango; Moses Joloba; W Henry Boom; Ezekiel Mupere; Catherine M Stein Journal: Clin Epidemiol Date: 2015-10-13 Impact factor: 4.790