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
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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.

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Available from: Alberto Matteelli, Oct 18, 2014
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    • "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. "
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