PLoS ONE (Jan 2011)

Social, clinical and microbiological differential characteristics of tuberculosis among immigrants in Spain.

  • José-María García-García,
  • Rafael Blanquer,
  • Teresa Rodrigo,
  • Joan A Caylà,
  • José A Caminero,
  • Rafael Vidal,
  • Martí Casals,
  • Juan Ruiz-Manzano,
  • Working Group on Completion of Tuberculosis Treatment in Spain

DOI
https://doi.org/10.1371/journal.pone.0016272
Journal volume & issue
Vol. 6, no. 1
p. e16272

Abstract

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BackgroundTo identify the differential tuberculosis (TB) characteristics within the immigrant population with respect to natives in Spain.Methodology/principal findingsA prospective cohort study design was implemented to examine the TB cases diagnosed and starting standard antituberculous treatment in Spain, between January 1st 2006 and March 31st 2007. A logistic regression analysis was performed to determine differential characteristics. 1,490 patients were included in the study population, 1,048 natives and 442 (29.7%) immigrants. According to the multivariate analysis, the following variables were significantly associated with immigrant TB cases: younger age (OR = 3.79; CI:2.16-6.62), living in group situation (OR = 7.61; CI:3.38-12.12), lower frequency of disabled (OR:0.08; CI:0.02-0.26) and retired (OR:0.21; CI:0.09-0.48) employment status, lower frequency of pulmonary disease presentation (OR = 0.47; CI:0.24-0.92), primary or emergency care admission (OR = 1.80; CI:1.05-3.06 and OR = 2.16; CI:1.36-3.45), drug resistance (OR = 1.86; CI:1.01-3.46), treatment default (OR:2.12; CI:1.18-3.81), lower frequency of alcohol and cigarette consumption (OR = 2.10; CI:1.42-3.11 and OR = 2.85; CI:2.10-3.87 respectively), more directly observed treatment (OR = 1.68; CI:1.04-2.69), and poor understanding of TB disease and its treatment (OR = 3.11; CI:1.86-5.20). The low percentage of primary MDR-TB in the native population (0.1% vs. 2.2% of immigrants) should be noted.Conclusions/significanceThe differences show the need to introduce specific strategies in the management of TB within the immigrant population, including the improvement of social and work conditions.