Extrapulmonary tuberculosis among migrants in Europe, 1995 to 2017.
Extrapulmonary tuberculosis among migrants in Europe, 1995 to 2017.
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1995年至2017年，欧洲移民的肺外结核病。
DOI：
10.1016/j.cmi.2020.12.006
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Hargreaves S
中科院分区：
文献类型：
--
作者：
Hayward SE;Rustage K;Nellums LB;van der Werf MJ;Noori T;Boccia D;Friedland JS;Hargreaves S
欧洲移民中结核病病例的比例正在上升。肺外结核给诊断和治疗带来挑战，并导致严重的发病率和死亡率，但其在流动人口中的程度尚不清楚。我们评估了欧盟(EU)/欧洲自由贸易联盟（EFTA）移民肺外结核的模式。我们调查了移民与非移民中肺外结核病例的比例，以及特定疾病部位、报告的欧洲地区和移民原籍地区的差异。我们利用1995年至2017年从欧洲疾病预防和控制中心的欧洲监测系统收集的32个欧盟/欧洲自由贸易联盟国家的23年数据进行了横断面二级数据库分析。总共纳入1 270 896例结核病例，其中移民326 987例（25.7%），非移民943 909例（74.3%）。在移民中，45.2% （n = 147 814）为肺外结核病例，而非移民中为21.7% (n = 204 613) （p < 0.001）。淋巴、骨/关节和腹膜/消化道结核在迁移者中比非迁移者更常见。与西欧（35.7%,n = 89 498 / 250 517）和北欧（41.8%,n = 101 792 / 243 381）相比，东欧（17.4%,n = 98 656 / 566 170）和南欧（29.6%,n = 62 481 / 210 828）的肺外结核比例较低。来自东南亚和撒哈拉以南非洲的移民患肺外疾病的风险最高，分别为62.0%（89 353例中n = 55 401例）和54.5%（70 378例中n = 38 327例）。在欧盟/欧洲自由贸易联盟的结核病病例中，肺外疾病在移民中比在非移民中更为常见。有必要提高临床对肺外结核的认识，并将其检测纳入筛查规划。
The proportion of tuberculosis (TB) cases occurring in migrants in Europe is increasing. Extrapulmonary TB poses challenges in diagnosis and treatment and causes serious morbidity and mortality, yet its extent in migrant populations is unclear. We assessed patterns of extrapulmonary TB in migrants across the European Union (EU)/European Free Trade Association (EFTA). We investigated the proportion of extrapulmonary TB cases among migrants versus non-migrants, and variations by specific site of disease, reporting European region, and migrant region of origin. We carried out a cross-sectional secondary database analysis, utilizing 23 years of data collected between 1995 and 2017 from the European Surveillance System of the European Centre for Disease Prevention and Control for 32 EU/EFTA countries. In total, 1 270 896 TB cases were included, comprising 326 987 migrants (25.7%) and 943 909 non-migrants (74.3%). Of TB cases among migrants, 45.2% (n = 147 814) were extrapulmonary compared to 21.7% (n = 204 613) among non-migrants (p < 0.001). Lymphatic, bone/joint and peritoneal/digestive TB were more common among migrant than non-migrant extrapulmonary cases. A lower proportion of extrapulmonary TB was seen in Eastern Europe (17.4%, n = 98 656 of 566 170) and Southern Europe (29.6%, n = 62 481 of 210 828) compared with Western (35.7%, n = 89 498 of 250 517) and Northern Europe (41.8%, n = 101 792 of 243 381). Migrants from South-East Asia and Sub-Saharan Africa were at highest risk of extrapulmonary disease, with 62.0% (n = 55 401 of 89 353) and 54.5% (n = 38 327 of 70 378) of cases, respectively, being extrapulmonary. Among TB cases in the EU/EFTA, extrapulmonary disease is significantly more common in migrants than in non-migrants. There is a need to improve clinical awareness of extrapulmonary TB and to integrate its detection into screening programmes.
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10
作者：
Kruijshaar, M. E.;Abubakar, I.
通讯作者：
Abubakar, I.
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影响因子：
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作者：
Forssbohm, M.;Zwahlen, M.;Rieder, H. L.
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Rieder, H. L.