Epidemiology and clinical features of tuberculosis in immigrants at an infectious diseases department in Madrid

Int J Tuberc Lung Dis. 2007 Jul;11(7):769-74.

Abstract

Objective: To perform a comparative analysis of tuberculous immigrants and native-born subjects at a tertiary centre in Madrid, Spain, from January 1990 to December 2002.

Results: The annual incidence of tuberculosis (TB) decreased from 141 in 1990 to 73 in 2002 despite an increase among immigrants (from 1% in 1990 to 27% in 2002), with 98 cases of TB among 1353 immigrants (overall rate 7.2%). The mean age was 30 years (6-77) and 54% were male. Most patients were from Latin America (55%) and Africa (37%). TB was diagnosed within 2 years of arrival in 69%. When performed, purified protein derivative test was positive in 88%. Human immunodeficiency virus co-infection was present in 6% vs. 37% among the native-born (P < 0.001). Pulmonary TB was the most frequent form in both groups (79% and 80%), with no differences in rates of sputum positivity (70% vs. 75%). Primary drug resistance was significantly higher among immigrants (13% vs. <6% among the native-born, P < 0.05). Initial four-drug regimens were followed by all immigrants. Overall, 82% of the patients were cured, one died due to disseminated disease (1%), and follow-up data were incomplete in 17 (17%).

Conclusion: TB among immigrants was clinically similar, but was not related to the common risk factors observed in native-born subjects. Given the higher prevalence of primary resistance in this population, initial four-drug regimens should be prescribed until susceptibility results are available.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Child
  • Cohort Studies
  • Communicable Diseases
  • Emigrants and Immigrants / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology
  • HIV Infections / ethnology
  • Hospital Units
  • Hospitals, Urban
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification
  • Probability
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Spain / epidemiology
  • Statistics, Nonparametric
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / epidemiology*
  • Tuberculosis, Pulmonary / ethnology
  • Urban Population
  • Young Adult