PLoS ONE
Volume 12, Issue 12, 2017

Socioeconomic status and biomedical risk factors in migrants and native tuberculosis patients in Italy (Article) (Open Access)

Pittalis S. , Piselli P.* , Contini S. , Gualano G. , Alma M.G. , Tadolini M. , Piccioni P. , Bocchino M. , Matteelli A. , Bonora S. , Biagio A.D. , Franzetti F. , Carbonara S. , Gori A. , Sotgiu G. , Palmieri F. , Ippolito G. , Girardi E.
  • a Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Roma, Italy
  • b Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Roma, Italy
  • c Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Roma, Italy
  • d Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Roma, Italy
  • e Ospedale San Camillo Forlanini, UOC Tisiologia e Broncopneumologia, Roma, Italy
  • f Alma Mater Studiorum Università di Bologna, Dipartimento di Scienze Mediche e Chirurgiche, UO Malattie Infettive, Bologna, Italy
  • g ASL Città di Torino, S.C. Pneumologia, Torino, Italy
  • h Università degli Studi Federico II, Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Napoli, Italy
  • i Spedali Civili di Brescia, Dipartimento di Scienze Cliniche e Sperimentali, Clinica Malattie Infettive, Brescia, Italy
  • j Università degli Studi di Torino, Dipartimento di Scienze Mediche, Clinica di Malattie Infettive, Torino, Italy
  • k Ospedale Policlinico San Martino, Clinica di Malattie Infettive, Genova, Italy
  • l Ospedale Sacco-Università di Milano, Malattie Infettive, Milano, Italy
  • m Policlinico Universitario Bari, Malattie Infettive, Bari, Italy
  • n Ospedale San Gerardo, Università di Milano Bicocca (Monza), Clinica di Malattie Infettive, Monza, Italy
  • o Università degli Studi di Sassari, Dipartimento di Medicina Clinica e Sperimentale, Sassari, Italy
  • p Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Roma, Italy
  • q Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Roma, Italy
  • r Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Roma, Italy

Abstract

Action on social determinants is a main component of the World Health Organization End Tuberculosis (TB) Strategy. The aim of the study was to collect information on socioeconomic characteristics and biomedical risk factors in migrant TB patients in Italy and compare it with data collected among Italian TB patients. A cross-sectional study was conducted among TB patients aged 18 years over a 12-months enrolment period in 12 major Italian hospitals. Information on education, employment, housing and income was collected, and European Union Statistics on Income and Living Conditions index was used to assess material deprivation. Among migrants, we also analyzed factors associated with severe material deprivation. Migrants were compared with younger (18–64 years) and older (65+ years) Italians patients. Out of 755 patients enrolled (with a median age of 42 years, interquartile range: 31–53), 65% were migrants. Pulmonary, microbiologically confirmed, and new cases were 80%, 73%, and 87% respectively. Prevalence of co-morbidities (i.e. diabetes, chronic kidney disease, neoplastic diseases and use of immunosuppressive drugs) was lower among migrants compared to Italian TB patients, while indicators of socioeconomic status, income and housing conditions were worst in migrants. Forty-six percent of migrants were severely deprived vs. 9% of Italians (p<0.0001, 11.3% and 5.5% among younger and older Italians, respectively). Among migrants, being male, older, irregular, unemployed, with a shorter time spent in Italy, a lower education level, and without a co-morbidity diagnosis were factors associated with severe material deprivation at multi-variable logistic regression. Moreover, socioeconomic indicators for Italian patients did not differ from those reported for the general Italian population, while migrant TB patients seem to have a higher prevalence of severe material deprivation than other migrants residing in Italy. Intervention to address the needs of this population are urgent. © 2017 Pittalis 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

unemployment educational status multicenter study clinical trial neoplasm poverty sex ratio human comorbidity middle aged diabetes mellitus Aged housing chronic disease Cross-Sectional Studies Young Adult income social status migrant cross-sectional study Humans male Italian (citizen) female Socioeconomic Factors tuberculosis risk factor Risk Factors socioeconomics immunosuppressive agent prevalence Incidence Article major clinical study adult migration drug use Italy Transients and Migrants social class disease association chronic kidney failure
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85038889345&doi=10.1371%2fjournal.pone.0189425&partnerID=40&md5=d0da2b80ab2c3ae8caef3a3f27212c83
DOI: 10.1371/journal.pone.0189425
ISSN: 19326203
Cited by: 2
Original Language: English