Although the incidence of tuberculosis (TB) has been decreasing in the European Union/European Economic Area (EU/EEA) in recent decades, specific subgroups of the population, such as immigrants, remain at high risk of the disease. Immigration from areas of high incidence is thought to have fuelled the resurgence of TB in areas of low incidence. Indeed, while immigrants have a high risk of acquiring TB prior to migration, after migration they are exposed to additional risk factors for acquiring or reactivating TB infection, such as poverty, stressful living conditions, social inequalities, overcrowded housing, malnutrition, substance abuse and limited access to health care. In Italy as well, TB has increasingly become a disease for specific population subgroups such as immigrants and in urban settings often driven by reactivation of imported latent TB infection (LTBI). In this paper we present an analysis of the national scientific literature from recent years in order to estimate the burden of TB in foreign-born populations, to establish the burden of TB in migrants by gender, age group and country of origin as well as other relevant subgroups, and evaluate the clinical manifestations of latent or active tuberculosis and treatment response. © 2017, EDIMES Edizioni Medico Scientifiche. All rights reserved.

tuberculosis Review immigrants

genetics genotype treatment response immigrant HIV Infections Human immunodeficiency virus infection capreomycin poverty analytical parameters human comorbidity statistics and numerical data multidrug resistant tuberculosis Mycobacterium tuberculosis Tuberculosis, Multidrug-Resistant substance abuse disease carrier nonhuman Drug Resistance, Multiple, Bacterial kanamycin Humans migrant classification tuberculostatic agent Antitubercular Agents Treatment Outcome male latent tuberculosis Emigrants and Immigrants female tuberculosis risk factor Risk Factors Review gamma interferon prevalence isolation and purification Incidence multidrug resistance tuberculin test Disease Reservoirs isoniazid health care access Amikacin stressful living condition mycobacterium bovis mycobacterium africanum overcrowded housing social inequality microbiology Precipitating Factors malnutrition Italy Directly Observed Therapy rifampicin drug effect acquired immune deficiency syndrome Health Services Accessibility health care delivery