Differences found in patient characteristics of migrant tuberculosis sub-populations within low TB incidence European countries, 2014-2020

INTRODUCTION: In low TB incidence countries, prevention and care activities addressing migrant populations are essential for TB control. Understanding characteristics of TB patients in the migrant population is important for planning and providing appropriate care. This study aims to inform prevention and care strategies by describing characteristics of TB patients within migrant subpopulations in Europe to understand whether differences exist in their patient profiles.

METHODS: This cross-sectional descriptive study of migrants with TB reported to the European Surveillance System (2014-2020) from 23 low incidence European countries describes characteristics of different subgroups, according to TB epidemiological indicators and interval between arrival and notification.

RESULTS: Migrants with TB originating from very high TB incidence countries had the highest proportion of people living with HIV (7%) and highest extrapulmonary TB proportion (44%). Patients from high incidence countries had the highest proportion with previous TB diagnosis (14%), first line (12%) and multidrug (6%) resistances. Compared to all patients, patients arriving from the 10 countries with the highest crude incidence rates were on average 9 years younger (median age 25 vs 34) and more often male (M:F ratio 2.6 vs. 1.8). Patients notified < 2 years after arrival had higher proportions diagnosed with PTB (67%) and MDR-TB (4%), as well as people living with HIV (7%).

DISCUSSION: Unique patterns in patient characteristics were observed which varied by origin and destination. Improving European TB preparedness within the context of migration requires timely and complete international data alongside continuous access to quality TB care, not only at entry, and expanded opportunities for diagnosis given levels of extrapulmonary TB observed.