Philip Wikman-Jorgensen1, Rogelio López-Velez2, Jara Llenas-García3, Begoña Treviño4, Reyes Pascual5, Israel Molina6, Ángel Domínguez7, Diego Torrús8, José Manuel Ruiz Giardín9, Begoña Monge-Maillo2, Francesca F Norman2, Mónica Romero10, José A Perez-Molina2. 1. Hospital General Universitario de Elda, Alicante, Spain. Electronic address: wikman_phi@gva.es. 2. National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramon y Cajal Hospital, IRYCIS, Madrid, Spain. 3. Hospital Vega Baja, Orihuela, Alicante, Spain. 4. Unitat Medicina Tropical i Salut Internacional Vall d'Hebron-Drassanes, PROSICS, Barcelona, Spain. 5. Hospital General Universitario de Elda, Alicante, Spain; Departamento de Medicina Clinica, Universidad Miguel Hernández, San Juan de Alicante, Spain. 6. Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona, PROSICS Barcelona, Barcelona, Spain. 7. Hospital Universitario Virgen de la Macarena de Sevilla, Sevilla, Spain. 8. Hospital General Universitario de Alicante, Alicante, Spain. 9. Hospital Universitario de Fuenlabrada, Madrid, Spain. 10. Hospital General Universitario de Elda, Alicante, Spain.
Abstract
BACKGROUND: Tuberculosis (TB) is the leading cause of infectious disease mortality worldwide. We analysed active and latent TB infections (LTBI) from the Spanish Network for the Study of Imported Infectious Diseases by Travellers and Immigrants (+REDIVI). METHODS: Observational, retrospective, multicentre study of TB and LTBI registered in the +REDIVI network from October 2009 to December 2016. RESULTS: Of 1008 cases of LTBI, 884 (87.7%) were immigrants; 93 (4.5%), immigrants visiting friends and relatives (VFR); 2 (0.9%), VFR-travellers; and 29 (1.1%), travellers. Absolute (N = 157 vs. N = 75) and relative (12.5% vs. 5.9%) frequency decreased over the study period (p = 0.003). Median time to diagnosis was 24.6 months (females 50.3 vs males 11.9; p < 0.001). Of 448 TB cases, 405 (90.4%) were in immigrants; 30 (6.7%), VFR-immigrants; 6 (1.3%), VFR-travellers; and 7 (1.6%), travellers. Median time to diagnosis was 62.5 months (females 86.6 vs males 70.1; p = 0.0075). There were 8 multidrug resistant TB cases and 1 extensively drug resistant case of TB, all in immigrants. CONCLUSION: TB was frequently diagnosed more than 5 years after arrival in Spain. Screening programmes for TB and LTBI in immigrants should be considered beyond this time point. Women showed a higher diagnostic delay for both latent and active TB.
BACKGROUND:Tuberculosis (TB) is the leading cause of infectious disease mortality worldwide. We analysed active and latent TB infections (LTBI) from the Spanish Network for the Study of Imported Infectious Diseases by Travellers and Immigrants (+REDIVI). METHODS: Observational, retrospective, multicentre study of TB and LTBI registered in the +REDIVI network from October 2009 to December 2016. RESULTS: Of 1008 cases of LTBI, 884 (87.7%) were immigrants; 93 (4.5%), immigrants visiting friends and relatives (VFR); 2 (0.9%), VFR-travellers; and 29 (1.1%), travellers. Absolute (N = 157 vs. N = 75) and relative (12.5% vs. 5.9%) frequency decreased over the study period (p = 0.003). Median time to diagnosis was 24.6 months (females 50.3 vs males 11.9; p < 0.001). Of 448 TB cases, 405 (90.4%) were in immigrants; 30 (6.7%), VFR-immigrants; 6 (1.3%), VFR-travellers; and 7 (1.6%), travellers. Median time to diagnosis was 62.5 months (females 86.6 vs males 70.1; p = 0.0075). There were 8 multidrug resistant TB cases and 1 extensively drug resistant case of TB, all in immigrants. CONCLUSION: TB was frequently diagnosed more than 5 years after arrival in Spain. Screening programmes for TB and LTBI in immigrants should be considered beyond this time point. Women showed a higher diagnostic delay for both latent and active TB.
Authors: Tanya R Diefenbach-Elstob; Balqis Alabdulkarim; Paromita Deb-Rinker; Jeffrey M Pernica; Guido Schwarzer; Dick Menzies; Ian Shrier; Kevin Schwartzman; Christina Greenaway Journal: J Travel Med Date: 2021-01-06 Impact factor: 8.490