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

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Langholz Kristensen, Kristina ; Lillebaek, Troels ; Holm Petersen, Joergen ; Hargreaves, Sally ; Nellums, Laura B ; Friedland, Jon S ; Andersen, Peter Henrik ; Ravn, Pernille ; Norredam, Marie. / Tuberculosis incidence among migrants according to migrant status : a cohort study, Denmark, 1993 to 2015. I: Eurosurveillance. 2019 ; Bind 24, Nr. 44.

Bibtex

@article{9263428777144e5f88e4172509fdf927,
title = "Tuberculosis incidence among migrants according to migrant status: a cohort study, Denmark, 1993 to 2015",
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.",
author = "{Langholz Kristensen}, Kristina and Troels Lillebaek and {Holm Petersen}, Joergen and Sally Hargreaves and Nellums, {Laura B} and Friedland, {Jon S} and Andersen, {Peter Henrik} and Pernille Ravn and Marie Norredam",
year = "2019",
doi = "10.2807/1560-7917.ES.2019.24.44.1900238",
language = "English",
volume = "24",
journal = "Eurosurveillance",
issn = "1560-7917",
publisher = "Centre Europeen pour la Surveillance Epidemiologique du SIDA",
number = "44",

}

RIS

TY - JOUR

T1 - Tuberculosis incidence among migrants according to migrant status

T2 - a cohort study, Denmark, 1993 to 2015

AU - Langholz Kristensen, Kristina

AU - Lillebaek, Troels

AU - Holm Petersen, Joergen

AU - Hargreaves, Sally

AU - Nellums, Laura B

AU - Friedland, Jon S

AU - Andersen, Peter Henrik

AU - Ravn, Pernille

AU - Norredam, Marie

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

U2 - 10.2807/1560-7917.ES.2019.24.44.1900238

DO - 10.2807/1560-7917.ES.2019.24.44.1900238

M3 - Journal article

VL - 24

JO - Eurosurveillance

JF - Eurosurveillance

SN - 1560-7917

IS - 44

ER -

ID: 58311458