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Migrant tuberculosis: the extent of transmission in a low burden country
BACKGROUND: Human migration caused by political unrest, wars and poverty is a major topic in international health. Infectious diseases like tuberculosis follow their host, with potential impact on both the migrants and the population in the recipient countries. In this study, we evaluate Mycobacteri...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342118/ https://www.ncbi.nlm.nih.gov/pubmed/22423983 http://dx.doi.org/10.1186/1471-2334-12-60 |
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author | Kamper-Jørgensen, Zaza Andersen, Aase Bengaard Kok-Jensen, Axel Kamper-Jørgensen, Mads Bygbjerg, Ib Christian Andersen, Peter Henrik Thomsen, Vibeke Østergaard Lillebaek, Troels |
author_facet | Kamper-Jørgensen, Zaza Andersen, Aase Bengaard Kok-Jensen, Axel Kamper-Jørgensen, Mads Bygbjerg, Ib Christian Andersen, Peter Henrik Thomsen, Vibeke Østergaard Lillebaek, Troels |
author_sort | Kamper-Jørgensen, Zaza |
collection | PubMed |
description | BACKGROUND: Human migration caused by political unrest, wars and poverty is a major topic in international health. Infectious diseases like tuberculosis follow their host, with potential impact on both the migrants and the population in the recipient countries. In this study, we evaluate Mycobacterium tuberculosis transmission between the national population and migrants in Denmark. METHODS: Register study based on IS6110-RFLP results from nationwide genotyping of tuberculosis cases during 1992 through 2004. Cases with 100% identical genotypes were defined as clustered and part of a transmission chain. Origin of clusters involving both Danes and migrants was defined as Danish/migrant/uncertain. Subsequently, the proportion of cases likely infected by the "opposite" ethnic group was estimated. RESULTS: 4,631 cases were included, representing 99% of culture confirmed cases during 1992 through 2004. Migrants contributed 61.6% of cases. Up to 7.9% (95% CI 7.0-8.9) of migrants were infected by Danes. The corresponding figure was 5.8% (95% CI 4.8-7.0) for Danes. Thus, transmission from Danes to migrants occurred up to 2.5 (95% CI 1.8-3.5) times more frequent than vice versa (OR = 1). A dominant strain, Cluster-2, was almost exclusively found in Danes, particular younger-middle-aged males. CONCLUSIONS: Transmission between Danes and migrants is limited, and risk of being infected by the "opposite" ethnic group is highest for migrants. TB-control efforts should focus on continues micro-epidemics, e.g. with Cluster-2 in Danes, prevention of reactivation TB in high-risk migrants, and outbreaks in socially marginalized migrants, such as Somalis and Greenlanders. Fears that TB in migrants poses a threat for resident Danes seem exaggerated and unjustified. We believe this to be true for other low incidence countries as well. |
format | Online Article Text |
id | pubmed-3342118 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-33421182012-05-03 Migrant tuberculosis: the extent of transmission in a low burden country Kamper-Jørgensen, Zaza Andersen, Aase Bengaard Kok-Jensen, Axel Kamper-Jørgensen, Mads Bygbjerg, Ib Christian Andersen, Peter Henrik Thomsen, Vibeke Østergaard Lillebaek, Troels BMC Infect Dis Research Article BACKGROUND: Human migration caused by political unrest, wars and poverty is a major topic in international health. Infectious diseases like tuberculosis follow their host, with potential impact on both the migrants and the population in the recipient countries. In this study, we evaluate Mycobacterium tuberculosis transmission between the national population and migrants in Denmark. METHODS: Register study based on IS6110-RFLP results from nationwide genotyping of tuberculosis cases during 1992 through 2004. Cases with 100% identical genotypes were defined as clustered and part of a transmission chain. Origin of clusters involving both Danes and migrants was defined as Danish/migrant/uncertain. Subsequently, the proportion of cases likely infected by the "opposite" ethnic group was estimated. RESULTS: 4,631 cases were included, representing 99% of culture confirmed cases during 1992 through 2004. Migrants contributed 61.6% of cases. Up to 7.9% (95% CI 7.0-8.9) of migrants were infected by Danes. The corresponding figure was 5.8% (95% CI 4.8-7.0) for Danes. Thus, transmission from Danes to migrants occurred up to 2.5 (95% CI 1.8-3.5) times more frequent than vice versa (OR = 1). A dominant strain, Cluster-2, was almost exclusively found in Danes, particular younger-middle-aged males. CONCLUSIONS: Transmission between Danes and migrants is limited, and risk of being infected by the "opposite" ethnic group is highest for migrants. TB-control efforts should focus on continues micro-epidemics, e.g. with Cluster-2 in Danes, prevention of reactivation TB in high-risk migrants, and outbreaks in socially marginalized migrants, such as Somalis and Greenlanders. Fears that TB in migrants poses a threat for resident Danes seem exaggerated and unjustified. We believe this to be true for other low incidence countries as well. BioMed Central 2012-03-18 /pmc/articles/PMC3342118/ /pubmed/22423983 http://dx.doi.org/10.1186/1471-2334-12-60 Text en Copyright ©2012 Kamper-Jørgensen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Kamper-Jørgensen, Zaza Andersen, Aase Bengaard Kok-Jensen, Axel Kamper-Jørgensen, Mads Bygbjerg, Ib Christian Andersen, Peter Henrik Thomsen, Vibeke Østergaard Lillebaek, Troels Migrant tuberculosis: the extent of transmission in a low burden country |
title | Migrant tuberculosis: the extent of transmission in a low burden country |
title_full | Migrant tuberculosis: the extent of transmission in a low burden country |
title_fullStr | Migrant tuberculosis: the extent of transmission in a low burden country |
title_full_unstemmed | Migrant tuberculosis: the extent of transmission in a low burden country |
title_short | Migrant tuberculosis: the extent of transmission in a low burden country |
title_sort | migrant tuberculosis: the extent of transmission in a low burden country |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342118/ https://www.ncbi.nlm.nih.gov/pubmed/22423983 http://dx.doi.org/10.1186/1471-2334-12-60 |
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