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Tuberculosis amongst foreign-born and nationals: different delays, different risk factors
BACKGROUND: Delay in Tuberculosis (TB) diagnosis affects foreign-born and nationals in different ways, especially in low-incidence countries. This study characterises total delay and its components amongst foreign-born individuals in Portugal. Additionally, we identify risk factors for each type of...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8427946/ https://www.ncbi.nlm.nih.gov/pubmed/34496792 http://dx.doi.org/10.1186/s12879-021-06635-1 |
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author | Moniz, Marta Soares, Patrícia Leite, Andreia Nunes, Carla |
author_facet | Moniz, Marta Soares, Patrícia Leite, Andreia Nunes, Carla |
author_sort | Moniz, Marta |
collection | PubMed |
description | BACKGROUND: Delay in Tuberculosis (TB) diagnosis affects foreign-born and nationals in different ways, especially in low-incidence countries. This study characterises total delay and its components amongst foreign-born individuals in Portugal. Additionally, we identify risk factors for each type of delay and compare their effects between foreign-born and nationals. METHODS: We analysed data from the Portuguese TB surveillance system and included individuals with pulmonary TB (PTB), notified between 2008 and 2017. We described patient, healthcare, and total delays. Cox regression was used to identify factors associated with each type of delay. All analyses were stratified according to the origin country: nationals (those born in Portugal) and foreign-born. RESULTS: Compared with nationals, foreign-born persons presented statistically significant and longer median total and patient delays (Total: 67 vs. 63; Patient: 44 vs. 36 days), and lower healthcare services delays (7 vs. 9 days). Risk factors for delayed diagnosis differed between foreign-born and nationals. Being unemployed, having drug addiction, and having comorbidities were identified as risk factors for delayed diagnosis in national individuals but not in foreigners. Alcohol addiction was the only factor identified for healthcare delay for both populations: foreign-born (Hazard Ratio 1.34 [95% confidence interval 1.17;1.53]); nationals (Hazard Ratio 1.20 [95% confidence interval 1.13;1.27]). CONCLUSIONS: Foreign-born individuals with PTB take longer to seek health care. While no specific risk factors were identified, more in-depth studies are required to identify barriers and support public health intervention to address PTB diagnosis delay in foreign-born individuals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06635-1. |
format | Online Article Text |
id | pubmed-8427946 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-84279462021-09-10 Tuberculosis amongst foreign-born and nationals: different delays, different risk factors Moniz, Marta Soares, Patrícia Leite, Andreia Nunes, Carla BMC Infect Dis Research BACKGROUND: Delay in Tuberculosis (TB) diagnosis affects foreign-born and nationals in different ways, especially in low-incidence countries. This study characterises total delay and its components amongst foreign-born individuals in Portugal. Additionally, we identify risk factors for each type of delay and compare their effects between foreign-born and nationals. METHODS: We analysed data from the Portuguese TB surveillance system and included individuals with pulmonary TB (PTB), notified between 2008 and 2017. We described patient, healthcare, and total delays. Cox regression was used to identify factors associated with each type of delay. All analyses were stratified according to the origin country: nationals (those born in Portugal) and foreign-born. RESULTS: Compared with nationals, foreign-born persons presented statistically significant and longer median total and patient delays (Total: 67 vs. 63; Patient: 44 vs. 36 days), and lower healthcare services delays (7 vs. 9 days). Risk factors for delayed diagnosis differed between foreign-born and nationals. Being unemployed, having drug addiction, and having comorbidities were identified as risk factors for delayed diagnosis in national individuals but not in foreigners. Alcohol addiction was the only factor identified for healthcare delay for both populations: foreign-born (Hazard Ratio 1.34 [95% confidence interval 1.17;1.53]); nationals (Hazard Ratio 1.20 [95% confidence interval 1.13;1.27]). CONCLUSIONS: Foreign-born individuals with PTB take longer to seek health care. While no specific risk factors were identified, more in-depth studies are required to identify barriers and support public health intervention to address PTB diagnosis delay in foreign-born individuals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06635-1. BioMed Central 2021-09-08 /pmc/articles/PMC8427946/ /pubmed/34496792 http://dx.doi.org/10.1186/s12879-021-06635-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Moniz, Marta Soares, Patrícia Leite, Andreia Nunes, Carla Tuberculosis amongst foreign-born and nationals: different delays, different risk factors |
title | Tuberculosis amongst foreign-born and nationals: different delays, different risk factors |
title_full | Tuberculosis amongst foreign-born and nationals: different delays, different risk factors |
title_fullStr | Tuberculosis amongst foreign-born and nationals: different delays, different risk factors |
title_full_unstemmed | Tuberculosis amongst foreign-born and nationals: different delays, different risk factors |
title_short | Tuberculosis amongst foreign-born and nationals: different delays, different risk factors |
title_sort | tuberculosis amongst foreign-born and nationals: different delays, different risk factors |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8427946/ https://www.ncbi.nlm.nih.gov/pubmed/34496792 http://dx.doi.org/10.1186/s12879-021-06635-1 |
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