Abstract
Background: The incidence of tuberculosis (TB) among the native population continues to decrease, resulting in a higher proportion of foreign-born cases.
The aim of this study was to identify the differential characteristics of TB within the immigrant population with respect to natives in the Health District of South Granada (HDSG).
Methods: This was a prospective study of all cases of TB diagnosed in the HDSG during the period 2003 to 2010. Immigration-related variables were assessed using bivariate analysis. Statistical significance was set at p<0.05 in all cases. Data was analysed using IBM SPSS Statistical 19.
Results: 319 TB cases were diagnosed: 247 natives and 72 (22.6%) immigrants. The following variables were significantly associated with immigrant TB cases: age <35 years (64.1% vs 26.4% p<0.001 OR=4.90; CI:2.70-9.00), higher percentage of cavitation (32.8% vs 17.8% p=0.011 OR=2.26; CI:1.20-4.20), higher percentage of smear-positive cases (51.6% vs 37.2% p =0.042 OR=1.80; CI: 1.02-3.16), higher diagnostic delay (median 32 days vs 21 days, p=0.043) and lower mortality (1.4% vs 10.7% p=0.026 OR=0.12; CI:0.16-0.89). No other significant differences in treatment conclusion, site or clinical characteristics were observed between the 2 groups.
The percentage of foreign-born TB cases increased from under 5% in 2003 to 50% in 2010. More than half came from either Romania (35%) or Morocco (21%).
Conclusions: The incidence of TB has remained constant in HDSG due to the increase in cases among immigrants. Compared with native TB, immigrant TB patients were younger and had a longer diagnostic delay and more advanced disease, indicating poorer TB control. Strategies for earlier diagnosis of TB in immigrants are mandatory.
- © 2013 ERS