J Paulino1, A Martins2, M Machado3, M Gomes2, A R Gaio4, R Duarte5. 1. Faculty of Medicine, University of Porto, Praça de Gomes Teixeira, 4099-002 Porto, Portugal. joaot.paulino@sapo.pt. 2. Epidemiology Unit, Institute of Public Health, University of Porto, Porto, Portugal. 3. Department of Mathematic, Faculty of Sciences, University of Porto, Porto, Portugal. 4. Department of Mathematic, Faculty of Sciences, and Centre of Mathematics, University of Porto, Porto, Portugal. 5. Epidemiology Unit, Institute of Public Health, and Chest Disease Centre, Vila Nova de Gaia, and Pulmonology, Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, and Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
Abstract
BACKGROUND: Tuberculosis (TB) is a major global health problem, and during the last 20 years, industrialised countries have shown similar patterns in TB notifications: decreasing TB incidence in native populations and increasing incidence in foreign-born populations. OBJECTIVES: To characterise risk factors associated with TB among native- and foreign-born TB patients in Portugal and identify barriers to the management of foreign cases. METHODS: Analysis of the data from the national tuberculosis surveillance system and data from an online survey of physicians managing TB cases in the country. RESULTS: Risk factors in the two populations differed. Foreign-born patients were younger, less likely to use drugs or alcohol and had fewer comorbidities. They were also more likely to be human immunodeficiency virus positive, to be employed and to be homeless/living in shelters. The outcome of the disease and the time to diagnosis were not significantly different between the two populations. The most important barriers to the management of foreign-born TB cases were language and fear of deportation. CONCLUSIONS: As there are significant differences between the two populations, different TB control strategies should be implemented in the two populations.
BACKGROUND:Tuberculosis (TB) is a major global health problem, and during the last 20 years, industrialised countries have shown similar patterns in TB notifications: decreasing TB incidence in native populations and increasing incidence in foreign-born populations. OBJECTIVES: To characterise risk factors associated with TB among native- and foreign-born TB patients in Portugal and identify barriers to the management of foreign cases. METHODS: Analysis of the data from the national tuberculosis surveillance system and data from an online survey of physicians managing TB cases in the country. RESULTS: Risk factors in the two populations differed. Foreign-bornpatients were younger, less likely to use drugs or alcohol and had fewer comorbidities. They were also more likely to be human immunodeficiency virus positive, to be employed and to be homeless/living in shelters. The outcome of the disease and the time to diagnosis were not significantly different between the two populations. The most important barriers to the management of foreign-born TB cases were language and fear of deportation. CONCLUSIONS: As there are significant differences between the two populations, different TB control strategies should be implemented in the two populations.
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