Factors influencing the higher incidence of tuberculosis among migrants and ethnic minorities in the UK.
Factors influencing the higher incidence of tuberculosis among migrants and ethnic minorities in the UK.
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DOI：
10.12688/f1000research.14476.2
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Tanner R
中科院分区：
文献类型：
--
作者：
Hayward S;Harding RM;McShane H;Tanner R
英国的移民和少数民族与普通人群相比，结核病（TB）的发病率更高。从历史上看，英国出生和移民人口之间的发病率差异主要归因于病原体暴露的差异，这是由于从高发地区迁移以及与出生或种族来源的结核病流行国家保持的跨国联系。然而，仅仅关注暴露并不能解决在一些潜伏感染人群中观察到的相对较高的疾病进展率。对移民和少数民族造成不成比例影响的一系列因素，包括遗传易感性、维生素D缺乏症和糖尿病和艾滋病毒等合并症，也增加了感染结核分枝杆菌或潜伏感染复发的可能性。此外，种族社会经济差异和移民本身的经历可能导致结核病发病率的差异，以及获得医疗保健的文化和结构性障碍。在这篇综述中，我们讨论了生物学和人类学的影响有关的病原体暴露的风险，感染或发展活动性疾病的脆弱性，并获得治疗的移民和少数民族在英国。
Migrants and ethnic minorities in the UK have higher rates of tuberculosis (TB) compared with the general population. Historically, much of the disparity in incidence between UK-born and migrant populations has been attributed to differential pathogen exposure, due to migration from high-incidence regions and the transnational connections maintained with TB endemic countries of birth or ethnic origin. However, focusing solely on exposure fails to address the relatively high rates of progression to active disease observed in some populations of latently infected individuals. A range of factors that disproportionately affect migrants and ethnic minorities, including genetic susceptibility, vitamin D deficiency and co-morbidities such as diabetes mellitus and HIV, also increase vulnerability to infection with Mycobacterium tuberculosis (M.tb) or reactivation of latent infection. Furthermore, ethnic socio-economic disparities and the experience of migration itself may contribute to differences in TB incidence, as well as cultural and structural barriers to accessing healthcare. In this review, we discuss both biological and anthropological influences relating to risk of pathogen exposure, vulnerability to infection or development of active disease, and access to treatment for migrant and ethnic minorities in the UK.