Tuberculosis incidence in foreign-born people residing in European countries in 2020

Author:

Vasiliu Anca1,Köhler Niklas234,Altpeter Ekkehardt5,Ægisdóttir Tinna Rán6,Amerali Marina7,de Oñate Wouter Arrazola89,Bakos Ágnes10,D’Amato Stefania11,Cirillo Daniela Maria12,van Crevel Reinout1314,Davidaviciene Edita15,Demuth Irène16,Domínguez Jose17,Duarte Raquel181920,Günther Gunar2122,Guthmann Jean-Paul23,Hatzianastasiou Sophia7,Holm Louise Hedevang24,Herrador Zaida25,Hribar Urška26,Huberty Conny16,Ibraim Elmira27,Jackson Sarah28,Jensenius Mogens29,Josefsdottir Kamilla Sigridur30,Koch Anders3124,Korzeniewska-Kosela Maria32,Kuksa Liga33,Kunst Heinke34,Lienhardt Christian3536,Mahler Beatrice3727,Makek Mateja Janković3839,Muylle Inge40,Normark Johan4142,Pace-Asciak Analita43,Petrović Goranka44,Pieridou Despo45,Russo Giulia12,Rzhepishevska Olena46,Salzer Helmut J.F.4748,Marques Marta Sá18,Schmid Daniela49,Solovic Ivan5051,Sukholytka Mariya52,Svetina Petra53,Tyufekchieva Mariya54,Vasankari Tuula5556,Viiklepp Piret57,Villand Kersti57,Wallenfels Jiri58,Wesolowski Stefan32,Mandalakas Anna-Maria41,Martinez Leonardo59,Zenner Dominik6061,Lange Christoph4123ORCID,

Affiliation:

1. Baylor College of Medicine, Department of Pediatrics, Global and Immigrant Health, Global Tuberculosis Program, Houston, Texas, United States

2. Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany

3. German Center for Infection Research (DZIF), TTU-TB, Borstel, Germany

4. Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany

5. Swiss Federal Office of Public Health, Division of Communicable Diseases, Bern, Switzerland

6. The National University Hospital of Iceland, Pharmaceutical Services, Reykjavik, Iceland

7. Tuberculosis Control Office, Department of Respiratory Infections, Directorate for Epidemiological Surveillance & Intervention, National Public Health Organization (NPHO), Athens, Greece

8. Flemish Association of Respiratory Health and TB Control, Leuven, Belgium

9. Belgian Lung and Tuberculosis Association, Brussels, Belgium

10. Koranyi National Institute for Pulmonology, Budapest, Hungary

11. Prevention of Communicable Diseases and International Prophylaxis, General Direction of Health Prevention, Ministry of Health of Italy, Rome, Italy

12. Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy

13. Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom

14. Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands

15. Vilnius University hospital Santaros Klinikos, Department of Tuberculosis State information system, Vilnius, Lithuania

16. Health Directorate of Luxembourg, Luxembourg

17. Institut d’Investigació Germans Trias i Pujol; Universitat Autònoma de Barcelona; CIBER Enfermedades Respiratorias; INNOVA4TB consortium Badalona, Barcelona, Spain

18. Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal

19. ISPUP – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal

20. ICBAS – Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto

21. Department of Medical Sciences, School of Medicine, University of Namibia, Windhoek, Namibia

22. Department of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital, University of Bern, Switzerland

23. Division of Infectious Diseases, Santé publique France, Saint-Maurice, France

24. Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark

25. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain

26. Tuberculosis Register of the Republic of Slovenia, University Clinic Golnik, Golnik, Slovenia

27. Marius Nasta Institute of Pulmonology, Bucharest, Romania

28. Infectious Diseases; Health Service Executive Health Protection Surveillance Centre, Dublin, Ireland

29. Department of Infectious Diseases, Oslo University Hospital, Ullevaal, Norway

30. Centre for Health Security and Communicable Disease Control, Directorate of Health, Iceland

31. Department of Infectious Diseases, Rigshospitalet University Hospital, Copenhagen, Denmark

32. Department of Tuberculosis Epidemiology and Surveillance, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland

33. Riga East University Hospital, TB and Lung Disease Clinic, Riga, Latvia

34. Blizard Institute, The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom

35. Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom

36. Unité Unité Mixte Internationale 233 IRD – U1175 INSERM - Université de Montpellier, Institut de Recherche pour le Développement (IRD), Montpellier, France

37. Department Cardio-thoracic, Pneumophtisiology II, University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania

38. University Hospital Centre Zagreb, Department for Lung diseases, Zagreb, Croatia

39. University of Zagreb, School of Medicine Zagreb, Croatia

40. Division of Pneumology, Onze-Lieve-Vrouw Ziekenhuis (OLV) Aalst, Aalst, Belgium

41. Wallenberg Centre for Molecular Medicine, Umeå University, Sweden

42. Department of Clinical Microbiology, Umeå University, Sweden

43. Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Superintendence of Public Health, Ministry for Health of Malta, La Valetta, Malta

44. Respiratory Diseases and Travel Medicine Department with Vaccination Unit, Infectious Diseases Epidemiology ServiceDepartment, Croatian Institute of Public Health, Zagreb, Croatia

45. Cyprus National Reference Laboratory for Mycobacteria, Microbiology Department, Nicosia General Hospital, Nicosia, Cyprus

46. Department of Chemistry, Department of Clinical Microbiology, Umeå University, Sweden

47. Faculty of Medicine, Johannes-Kepler-University, Linz, Austria and Ignaz Semmelweis Institut, Interuniversity Institute for Infection Resarch, Vienna, Austria

48. Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine 4- Pneumology, Kepler University Hospital, Linz, Austria

49. Unit for Infectious Diseases Diagnostics and Infectious Diseases Epidemiology, Centre for Pathophysiology, Infectious Diseases and Immunology, Medical University of Vienna, Vienna, Austria

50. Catholic University Ruzomberok, Ruzomberok, Slovakia

51. National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy, Slovakia

52. First Faculty of Medicine and Faculty Thomayer Hospital Prague, Czechia

53. National TB Program and Tuberculosis Registry of Republic of Slovenia, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia

54. Health Promotion and Prevention Unit, Directorate Public Health Protection and Health Control, Ministry of Health of Bulgaria, Sofia, Bulgaria

55. Finnish Lung Health Association (Filha ry), Helsinki, Finland

56. University of Turku, Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku, Finland

57. Estonian Tuberculosis Register, Dept. of Registries, National Institute for Health Development, Tallinn, Estonia

58. National TB Surveillance Unit, University Hospital Bulovka, Prague, Czechia

59. Boston University, School of Public Health, Department of Epidemiology, Boston, Massachusetts, United States

60. The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom

61. Global Public Health Unit, Wolfson Institute of Population Health Barts

Abstract

Background European-specific policies for tuberculosis (TB) elimination require identification of key populations that benefit from TB screening. Aim We aimed to identify groups of foreign-born individuals residing in European countries that benefit most from targeted TB prevention screening. Methods The Tuberculosis Network European Trials group collected, by cross-sectional survey, numbers of foreign-born TB patients residing in European Union (EU) countries, Iceland, Norway, Switzerland and the United Kingdom (UK) in 2020 from the 10 highest ranked countries of origin in terms of TB cases in each country of residence. Tuberculosis incidence rates (IRs) in countries of residence were compared with countries of origin. Results Data on 9,116 foreign-born TB patients in 30 countries of residence were collected. Main countries of origin were Eritrea, India, Pakistan, Morocco, Romania and Somalia. Tuberculosis IRs were highest in patients of Eritrean and Somali origin in Greece and Malta (both > 1,000/100,000) and lowest among Ukrainian patients in Poland (3.6/100,000). They were mainly lower in countries of residence than countries of origin. However, IRs among Eritreans and Somalis in Greece and Malta were five times higher than in Eritrea and Somalia. Similarly, IRs among Eritreans in Germany, the Netherlands and the UK were four times higher than in Eritrea. Conclusions Country of origin TB IR is an insufficient indicator when targeting foreign-born populations for active case finding or TB prevention policies in the countries covered here. Elimination strategies should be informed by regularly collected country-specific data to address rapidly changing epidemiology and associated risks.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

Reference27 articles.

1. Die Aetiologie der Tuberkulose.;Koch;Berl Klin Wschr.,1882

2. McAuliffe M, Triandafyllidou A. World Migration Report 2022. Geneva: International Organization for Migration (IOM); 2021. Available from: https://publications.iom.int/books/world-migration-report-2022

3. An overview of tuberculosis and migration.;Dhavan;Int J Tuberc Lung Dis,2017

4. European Centre for Disease Prevention and Control (ECDC), and World Health Organization Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2022 – 2020 data. Copenhagen: WHO Regional Office for Europe and Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/tuberculosis-surveillance-and-monitoring-europe-2022-2020-data

5. World Health Organization (WHO). Global Tuberculosis Report. Geneva: WHO; 2021. Available from: https://www.who.int/publications/i/item/9789240037021

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