PLoS ONE
Volume 10, Issue 6, 2015

Higher rate of tuberculosis in second generation migrants compared to native residents in a metropolitan setting in Western Europe (Article) (Open Access)

Marx F.M. , Fiebig L. , Hauer B. , Brodhun B. , Glaser-Paschke G. , Magdorf K. , Haas W.
  • a Department of Pediatric Pneumology and Immunology, Charité-Universita¨tsmedizin, Berlin, Germany, Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, United States
  • b Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
  • c Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
  • d Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
  • e Centre for Tuberculosis, Public Health Office Berlin-Lichtenberg, Berlin, Germany
  • f Department of Pediatric Pneumology and Immunology, Charité-Universita¨tsmedizin, Berlin, Germany
  • g Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany

Abstract

Background: In Western Europe, migrants constitute an important risk group for tuberculosis, but little is known about successive generations of migrants. We aimed to characterize migration among tuberculosis cases in Berlin and to estimate annual rates of tuberculosis in two subsequent migrant generations. We hypothesized that second generation migrants born in Germany are at higher risk of tuberculosis compared to native (non-migrant) residents. Methods: A prospective cross-sectional study was conducted. All tuberculosis cases reported to health authorities in Berlin between 11/2010 and 10/2011 were eligible. Interviews were conducted using a structured questionnaire including demographic data, migration history of patients and their parents, and language use. Tuberculosis rates were estimated using 2011 census data. Results: Of 314 tuberculosis cases reported, 154 (49.0%) participated. Of these, 81 (52.6%) were first-, 14 (9.1%) were second generation migrants, and 59 (38.3%) were native residents. The tuberculosis rate per 100,000 individuals was 28.3 (95CI: 24.0-32.6) in first-, 10.2 (95% CI: 6.1-16.6) in second generation migrants, and 4.6 (95%CI: 3.7-5.6) in native residents. When combining information from the standard notification variables country of birth and citizenship, the sensitivity to detect second generation migration was 28.6%. Conclusions: There is a higher rate of tuberculosis among second generation migrants compared to native residents in Berlin. This may be explained by presumably frequent contact and transmission within migrant populations. Second generation migration is insufficiently captured by the surveillance variables country of birth and citizenship. Surveillance systems in Western Europe should allow for quantifying the tuberculosis burden in this important risk group. © 2015 Marx et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

extrapulmonary tuberculosis prospective study Germany indigenous people Prospective Studies human infection rate risk assessment middle aged birthplace controlled study comparative study Aged Cross-Sectional Studies disease surveillance Young Adult cross-sectional study migrant Humans lung tuberculosis Adolescent Infant, Newborn male Emigrants and Immigrants preschool child female tuberculosis Infant Child, Preschool newborn high risk population Article disease transmission city major clinical study adult migration infection risk age distribution citizenship Berlin Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84935483439&doi=10.1371%2fjournal.pone.0119693&partnerID=40&md5=daa7c718c6074373572b45605bea6a51
DOI: 10.1371/journal.pone.0119693
ISSN: 19326203
Cited by: 19
Original Language: English