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. 2019 Oct;24(44):1900238.
doi: 10.2807/1560-7917.ES.2019.24.44.1900238.

Tuberculosis incidence among migrants according to migrant status: a cohort study, Denmark, 1993 to 2015

Kristina Langholz Kristensen  1   2 , Troels Lillebaek  1   3 , Joergen Holm Petersen  4 , Sally Hargreaves  5 , Laura B Nellums  6 , Jon S Friedland  5 , Peter Henrik Andersen  7 , Pernille Ravn  8 , Marie Norredam  9   10
Affiliations

Tuberculosis incidence among migrants according to migrant status: a cohort study, Denmark, 1993 to 2015

Kristina Langholz Kristensen et al. Euro Surveill. 2019 Oct.

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.

Keywords: asylum seekers; family-reunified; immigrants; migrants; public health; refugees; screening; tuberculosis.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure
Figure
Flow chart of the selection process of the final study cohort, including migrants and Danish-born, Denmark, 1993–2015
See this image and copyright information in PMC

References

    1. World Health Organization (WHO). Framework towards tuberculosis elimination in low-Incidence countries. Geneva: WHO; 2014. Available from: http://who.int/tb/publications/elimination_framework/en/ - PubMed
    1. Pareek M, Greenaway C, Noori T, Munoz J, Zenner D. The impact of migration on tuberculosis epidemiology and control in high-income countries: a review. BMC Med. 2016;14(1):48. 10.1186/s12916-016-0595-5 - DOI - PMC - PubMed
    1. World Health Organization (WHO). Tuberculosis country profile. Geneva: WHO;2017. Available from: https://www.who.int/tb/country/data/profiles/en/
    1. Lönnroth K, Mor Z, Erkens C, Bruchfeld J, Nathavitharana RR, van der Werf MJ, et al. Tuberculosis in migrants in low-incidence countries: epidemiology and intervention entry points. Int J Tuberc Lung Dis. 2017;21(6):624-37. 10.5588/ijtld.16.0845 - DOI - PubMed
    1. European Centre for Disease Prevention and Control (ECDC). Tuberculosis in Europe: From passive control to active elimination. Stockholm: ECDC; 2015. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publicat...

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