Epidemiology of tuberculosis in a low-incidence Italian region with high immigration rates differences between not Italy-born and Italy-born TB cases.docVIP

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Epidemiology of tuberculosis in a low-incidence Italian region with high immigration rates differences between not Italy-born and Italy-born TB cases.doc

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Epidemiology of tuberculosis in a low-incidence Italian region with high immigration rates differences between not Italy-born and Italy-born TB cases

Odoneetal.BMCPublicHealth2011,11:376 /1471-2458/11/376 RESEARCH ARTICLE OpenAccess Epidemiologyoftuberculosisinalow-incidence Italianregionwithhighimmigrationrates: differencesbetweennotItaly-bornandItaly-born TBcases AnnaOdone1*?,MatteoRiccò1?,MatteoMorandi2?,BiancaMBorrini3?,CesiraPasquarella1?andCarloSignorelli1? Abstract Background:EmiliaRomagna,anorthernItalianregion,hasapopulationof4.27million,ofwhich9.7%are immigrants.Theobjectiveofthisstudywastoinvestigatetheepidemiologyoftuberculosis(TB)duringtheperiod 1996-2006innotItaly-borncomparedtoItaly-borncases. Methods:DatawasobtainedfromtheRegionalTBsurveillancesystem,fromwherepersonaldata,clinicalfeatures andriskfactorsofallnotifiedTBcaseswereextracted. Results:5377TBcaseswerereported.TheproportionofimmigrantswithTB,overthetotalnumberofTBcases hadprogressivelyincreasedovertheyears,from19.1%to53.3%.InthenotItaly-bornpopulation,TBincidencewas higherthaninItalians(in2006:100.7casesper100000registerednotItaly-bornsubjectsand83.9/100000adding 20%ofestimatedirregularpresencestothedenominators.TBincidenceamongItalianswas6.5/100000Italians). AprogressiveriseinthenotItaly-bornincidentcaseswasobservedbutassociatedwithadeclineinTBincidence. NotItaly-borncaseswereyoungercomparedtotheItaly-borncases,andmorefrequentlyclassifiedas“newcases” (OR2.095%CI1.61-2.49foragegroup20-39);60.7%hadpulmonaryTB,31.6%extrapulmonaryand7.6% disseminatedTB.RiskfactorsforTBinthispopulationgroupwereconnectedtolowerincomestatus(homeless:OR 149.995%CI20.7-1083.3foragegroup40-59). Conclusions:Inlow-incidenceregions,preventionandcontrolofTBamongsub-groupsatrisksuchasthe foreign-bornpopulationisamatterofpublichealthconcern.Inaddition,increasingimmigrationratesmayaffect TBepidemiology.TBamongimmigrantsischaracterizedbyparticularclinicalfeaturesandriskfactors,whichshould beanalyzedinordertoplaneffectiveaction. Background hasrecentlycontributedtoreversethisdownwardtrend With 9.4 million new cases estimated in 2009 by the [4-6]andtothere-emergenceofTBas