Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
Volume 24, Issue 44, 2019

Tuberculosis incidence among migrants according to migrant status: a cohort study, Denmark, 1993 to 2015 (Article) (Open Access)

Langholz Kristensen K. , Lillebaek T. , Holm Petersen J. , Hargreaves S. , Nellums L.B. , Friedland J.S. , Andersen P.H. , Ravn P. , Norredam M.
  • a Department of Pulmonary and Infectious Diseases, Nordsjællands Hospital, Denmark, International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
  • b International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark, Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • c Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
  • d Institute for Infection & Immunity, University of London, St. George's, London, United Kingdom
  • e Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
  • f Institute for Infection & Immunity, University of London, St. George's, London, United Kingdom
  • g Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
  • h Department of Medicine, Infectious Disease Section, Herlev-Gentofte Hospital, Copenhagen, Denmark
  • i Department of Infectious Diseases, Section of Immigrants Medicine, University Hospital Hvidovre, Hvidovre, Denmark, Research Centre for Migration, Ethnicity and Health, University of Copenhagen, Copenhagen, Denmark

Abstract

BackgroundMigrants account for the majority of tuberculosis (TB) cases in low-incidence countries in western Europe. TB incidence among migrants might be influenced by patterns of migration, but this is not well understood.AimTo investigate differences in TB risk across migrant groups according to migrant status and region of origin.MethodsThis prospective cohort study included migrants ≥ 18 years of age who obtained residency in Denmark between 1 January 1993 and 31 December 2015, matched 1:6 to Danish-born individuals. Migrants were grouped according to legal status of residency and region of origin. Incidence rates (IR) and incidence rate ratios (IRR) were estimated by Poisson regression.ResultsThe cohort included 142,314 migrants. Migrants had significantly higher TB incidence (IR: 120/100,000 person-years (PY); 95% confidence interval (CI): 115-126) than Danish-born individuals (IR: 4/100,000 PY; 95% CI: 3-4). The IRR was significantly higher in all migrant groups compared with Danish-born (p < 0.01). A particularly higher risk was seen among family-reunified to refugees (IRR: 61.8; 95% CI: 52.7-72.4), quota refugees (IRR: 46.0; 95% CI: 36.6-57.6) and former asylum seekers (IRR: 45.3; 95% CI: 40.2-51.1), whereas lower risk was seen among family-reunified to Danish/Nordic citizens (IRR 15.8; 95% CI: 13.6-18.4) and family-reunified to immigrants (IRR: 16.9; 95% CI: 13.5-21.3).DiscussionAll migrants had higher TB risk compared with the Danish-born population. While screening programmes focus mostly on asylum seekers, other migrant groups with high risk of TB are missed. Awareness of TB risk in all high-risk groups should be strengthened and screening programmes should be optimised.

Author Keywords

Screening immigrants Migrants family-reunified Asylum seekers tuberculosis Refugees Public health

Index Keywords

[No Keywords available]
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85074742434&doi=10.2807%2f1560-7917.ES.2019.24.44.1900238&partnerID=40&md5=763f4b73173d47deb38600a33bfe0bcb
DOI: 10.2807/1560-7917.ES.2019.24.44.1900238
ISSN: 15607917
Original Language: English