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Tuberculosis transmission between foreign- and native-born populations in the EU/EEA: a systematic review

Sandgren, Andreas and Schepisi, Monica Sañé and Sotgiu, Giovanni and Huitric, Emma and Migliori, Giovanni Battista and Manissero, Davide and van der Werf, Marieke J. and Girardi, Enrico (2014) Tuberculosis transmission between foreign- and native-born populations in the EU/EEA: a systematic review. European respiratory journal, Vol. 43 (4), p. 1159-1171. ISSN 0903-1936. eISSN 1399-3003. Article.

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DOI: 10.1183/09031936.00117213

Abstract

Tuberculosis (TB) control programmes of many low TB incidence countries of the European Union/European Economic Area (EU/EEA) perceive challenges in controlling TB due to high numbers of TB in migrants from high-incidence countries.
To assess the extent of TB transmission from the foreign-born to the native-born population, we quantitatively investigated the dynamics of TB transmission between these populations in the EU/EEA, using published molecular epidemiological studies. We searched PubMed and EMBASE databases from 1990 to August 2012.
We identified 15 studies performed during 1992-2007 covering 12,366 cases, of which median (range) 49.2% (17.7%-86.4%) were foreign-born. The proportion of clustered isolates ranged between 8.5% and 49.1% of the total number of TB cases genotyped and among these, foreign-born cases were equally or more likely to have unique isolates compared to native-born cases. One third of the clusters were "mixed", i.e. composed of foreign- and native-born cases, involving 0-34.2% of all genotyped cases. Cross-transmission among foreign and native populations was bidirectional, with wide differences across studies.
This systematic review provides evidence that TB in a foreign-born population does not have a significant influence on TB in the native population in EU/EEA.

Item Type:Article
ID Code:10251
Status:Published
Refereed:Yes
Uncontrolled Keywords:Tuberculosis transmiss, migrants, TB incidence
Subjects:Area 06 - Scienze mediche > MED/01 Statistica medica
Divisions:002 Altri enti e centri di ricerca del Nord Sardegna > AOU -Azienda Ospedaliero Universitaria, Sassari
001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Biomediche
Publisher:European Respiratory Society Journals
ISSN:0903-1936
eISSN:1399-3003
Deposited On:31 Oct 2014 11:50

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