Genotyping analyses of tuberculosis transmission among immigrant residents in Italy

Clinical Science Department, Section of Infectious Diseases, L. Sacco Hospital, University of Milan, Milan, Italy.
Clinical Microbiology and Infection (Impact Factor: 5.77). 10/2009; 16(8):1149-54. DOI: 10.1111/j.1469-0691.2009.03080.x
Source: PubMed

ABSTRACT Clin Microbiol Infect 2010; 16: 1149–1154
We used DNA fingerprinting to analyse tuberculosis (TB) epidemiology in immigrant patients living in two major northern Italian urban areas. The study population included 1999 TB patients (1500 Italian-born and 499 immigrants). Univariate and multivariate logistic regression models were used to identify risk factors related to clustering similar proportions of immigrant and Italian-born patients (46%) had infection with TB strains that belonged to genetic clusters. This supports the hypothesis that the disease in foreign patients is more likely to have arisen from reactivation of latent infection acquired in the country of origin than from recent transmission. Gender, age, human immunodeficiency virus infection and drug resistance were not significantly linked to TB clustering. Risk factors associated with strain clustering were country of origin (Somalia, adjusted OR (AOR) 3.19, p 0.017; Peru, AOR 2.86, p 0.014; and Senegal, AOR 2.60, p 0.045) and city of residence. Immigrant status in the larger urban area was an independent risk factor for infection with clustered TB, as reinforced by a subanalysis of the Senegalese group. In conclusion, variations in TB transmission were observed among immigrants from different countries and even within national groups, where living conditions have been found to exert a profound impact. These results emphasize the importance of improving social integration of immigrant subjects in order to limit risks of TB transmission in developed countries.

Download full-text


Available from: Alberto Matteelli, Oct 18, 2014
14 Reads
  • Source
    • "The importance of TB contact locations such as community drop-in centers, bars, and parks, and social networks have been explored to great effect (Cook et al., 2007; Carter et al., 2009). Indeed, the movements of people in space and migrants, in particular, have contributed to the spread of TB in both developing (Long et al., 2008; Wei et al., 2009; Pace- Asciak et al., 2013) and developed countries (Haase et al., 2007; McPherson et al., 2008; Franzetti et al., 2010; Edelson and Phypers, 2011). An earlier study by Jia et al. (2008) reported a higher rate of TB prevalence in migrants than the local residents of Beijing. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Human mobility has played a major role in the spread of infectious diseases such as tuberculosis (TB) through transportation; however, its pattern and mechanism have remained unclear. This study used transport networks as a proxy for human mobility to generate the spatial process of TB incidence. It examined the association between TB incidence and four types of transport networks at the provincial level: provincial roads, national roads, highways, and railways. Geographical information systems and geospatial analysis were used to examine the spatial distribution of 2217 smear-positive TB cases reported between 2009 and 2011 in the Shandong province. The study involved factors such as population density and elevation difference in conjunction with the types of transport networks to predict the disease occurrence in space. It identified spatial clusters of TB incidence linked not only with transport networks of the regions but also differentiated by elevation. Our research findings provide evidence of targeting populous regions with well-connected transport networks for effective surveillance and control of TB transmission in Shandong.
    Journal of Transport Geography 06/2015; 46. DOI:10.1016/j.jtrangeo.2015.06.021 · 2.54 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Understanding the epidemiology of tuberculosis in migrant communities and designing adequate and comprehensive control strategies is a major challenge facing public health authorities in many low-prevalence countries. Asylum seekers are a particularly vulnerable subgroup of people who are required to live in hosting centres for several months waiting for their residence permit. Since September 2008, tuberculosis (TB) screening has been offered to all asylum seekers living in the hosting centre of Castelnuovo di Porto in Rome (C.A.R.A). This paper describes the results of this screening activity that aims to detect all asylum-seekers with active and latent TB infection, and provides an overview of the literature concerning TB screening among foreign-born people in low prevalence EU countries.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Clin Microbiol Infect 2013; 19: 292–297 The demographic characteristics of the population of Madrid, with a steady increase in immigrants, from 4.7% in 1998 to 17.4% in 2007, provide an opportunity to study in depth the transmission of TB. Our aim was to compare two 3-year longitudinal molecular studies of TB to define transmission patterns and predictors of clustering. Two prospective population-based molecular and epidemiological studies (2002–2004 and 2005–2007) of TB patients were conducted in nine urban districts in Madrid using the same methodology. During the period 2002–2007, 2248 cases of TB were reported, and the incidence decreased from 23.5 per 100 000 in 2002 to 20.8 in 2007 (p <0.001). A total of 1269 isolates were molecularly characterized and included in the study. The comparison between the two periods showed that the percentage of foreign-born patients among TB cases increased from 36.2% to 45.7% (p <0.001). Furthermore, the percentage of clustered cases decreased (36.6% vs. 30.6%; p 0.028), and this decline was associated with a decrease of clustered cases among men and people under 35 years. We also observed a decrease in cases belonging to clusters containing ≥6 people (14.2% vs. 8.2%; p <0.001), and in cases belonging to mixed clusters containing Spanish-born and foreign-born patients (18.5% vs. 11.1%, p <0.001). Our molecular epidemiology study provides clues to interpret the decrease in the incidence of TB in a context of steady increase of immigration. In our region, the decrease in the incidence of TB can be explained predominantly as a result of a decline in recent transmission.
    Clinical Microbiology and Infection 02/2012; 19(3). DOI:10.1111/j.1469-0691.2012.03794.x · 5.77 Impact Factor
Show more