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. 2002 Jul;8(7):679-84.
doi: 10.3201/eid0807.010482.

Persistent high incidence of tuberculosis in immigrants in a low-incidence country

Troels Lillebaek  1 , Ase B Andersen, Asger Dirksen, Else Smith, Lene T Skovgaard, Axel Kok-Jensen
Affiliations

Persistent high incidence of tuberculosis in immigrants in a low-incidence country

Troels Lillebaek et al. Emerg Infect Dis. 2002 Jul.

Abstract

Immigration from areas of high incidence is thought to have fueled the resurgence of tuberculosis (TB) in areas of low incidence. To reduce the risk of disease in low-incidence areas, the main countermeasure has been the screening of immigrants on arrival. This measure is based on the assumption of a prompt decline in the incidence of TB in immigrants during their first few years of residence in a country with low overall incidence. We have documented that this assumption is not true for 619 Somali immigrants reported in Denmark as having TB. The annual incidence of TB declined only gradually during the first 7 years of residence, from an initial 2,000 per 100,000 to 700 per 100,000. The decline was described by an exponential function with a half-time of 5.7 (95% confidence interval 4.0 to 9.7) years. This finding seriously challenges the adequacy of the customary practice of screening solely on arrival.

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Figures

Figure 1
Figure 1
Cases of pulmonary tuberculosis in Denmark over a 125-year period, based on national surveillance information: mortality rates and incidence.
Figure 2
Figure 2
Trends in number of reported cases of tuberculosis in Denmark over the last 15 years, by nationality.
Figure 3
Figure 3
Trend in the incidence of tuberculosis in Somali immigrants in Denmark, by duration of residence. The dotted line indicates the estimated incidence curve and t(1/2) the corresponding half-time, with confidence interval.
See this image and copyright information in PMC

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