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Higher Rate of Tuberculosis in Second Generation Migrants Compared to Native Residents in a Metropolitan Setting in Western Europe.

Marx FM, Fiebig L, Hauer B, Brodhun B, Glaser-Paschke G, Magdorf K, Haas W - PLoS ONE (2015)

Bottom Line: When combining information from the standard notification variables country of birth and citizenship, the sensitivity to detect second generation migration was 28.6%.This may be explained by presumably frequent contact and transmission within migrant populations.Second generation migration is insufficiently captured by the surveillance variables country of birth and citizenship.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Pneumology and Immunology, Charité -Universitätsmedizin, Berlin, Germany; Division of Global Health Equity, Brigham and Women's Hospital and Harvard Medical School, Boston, United States of America.

ABSTRACT

Background: In Western Europe, migrants constitute an important risk group for tuberculosis, but little is known about successive generations of migrants. We aimed to characterize migration among tuberculosis cases in Berlin and to estimate annual rates of tuberculosis in two subsequent migrant generations. We hypothesized that second generation migrants born in Germany are at higher risk of tuberculosis compared to native (non-migrant) residents.

Methods: A prospective cross-sectional study was conducted. All tuberculosis cases reported to health authorities in Berlin between 11/2010 and 10/2011 were eligible. Interviews were conducted using a structured questionnaire including demographic data, migration history of patients and their parents, and language use. Tuberculosis rates were estimated using 2011 census data.

Results: Of 314 tuberculosis cases reported, 154 (49.0%) participated. Of these, 81 (52.6%) were first-, 14 (9.1%) were second generation migrants, and 59 (38.3%) were native residents. The tuberculosis rate per 100,000 individuals was 28.3 (95CI: 24.0-32.6) in first-, 10.2 (95%CI: 6.1-16.6) in second generation migrants, and 4.6 (95%CI: 3.7-5.6) in native residents. When combining information from the standard notification variables country of birth and citizenship, the sensitivity to detect second generation migration was 28.6%.

Conclusions: There is a higher rate of tuberculosis among second generation migrants compared to native residents in Berlin. This may be explained by presumably frequent contact and transmission within migrant populations. Second generation migration is insufficiently captured by the surveillance variables country of birth and citizenship. Surveillance systems in Western Europe should allow for quantifying the tuberculosis burden in this important risk group.

No MeSH data available.


Related in: MedlinePlus

Distribution of first generation migrants by time since their immigration to Germany (N = 81).
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pone.0119693.g003: Distribution of first generation migrants by time since their immigration to Germany (N = 81).

Mentions: First generation migrants were younger than native residents (P<0.001), and two-third were male (Table 3). They had emigrated from Russia (10 cases; 12.3% of all patients), Turkey (7; 8.6%), Bulgaria (6; 7.4%), Cameroon (5; 6.2%), Poland (5; 6.2%), and 31 other countries (48; 59.3%). Immigrant patients by region of origin are shown in Fig 2. The majority of first generation migrants, 47 of 81 (58.0%), had immigrated less than 10 years before being notified (28.4% less than two years), and 69 (85.2%) had immigrated less than 20 years before being notified (Fig 3). The median time between immigration and notification was 8 years (IQR: 1–18 years). Seventy-eight provided information about the personal reason for immigration: 37 (47.4%) had joined family already living in Germany, 13 (16.7%) were asylum seekers, 12 (15.4%) had immigrated as guest workers, 9 (11.5%) were guest or exchange students, 6 (7.7%) had a status of late repatriates, and one (1.3%) was au-pair. Of 80 first generation migrants providing information, twenty-three (28.8%) reported to visit their home country at least once a year, 26 (32.5%) less than once a year, and 31 (38.8%) had not been visiting their home country since immigration.


Higher Rate of Tuberculosis in Second Generation Migrants Compared to Native Residents in a Metropolitan Setting in Western Europe.

Marx FM, Fiebig L, Hauer B, Brodhun B, Glaser-Paschke G, Magdorf K, Haas W - PLoS ONE (2015)

Distribution of first generation migrants by time since their immigration to Germany (N = 81).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4465484&req=5

pone.0119693.g003: Distribution of first generation migrants by time since their immigration to Germany (N = 81).
Mentions: First generation migrants were younger than native residents (P<0.001), and two-third were male (Table 3). They had emigrated from Russia (10 cases; 12.3% of all patients), Turkey (7; 8.6%), Bulgaria (6; 7.4%), Cameroon (5; 6.2%), Poland (5; 6.2%), and 31 other countries (48; 59.3%). Immigrant patients by region of origin are shown in Fig 2. The majority of first generation migrants, 47 of 81 (58.0%), had immigrated less than 10 years before being notified (28.4% less than two years), and 69 (85.2%) had immigrated less than 20 years before being notified (Fig 3). The median time between immigration and notification was 8 years (IQR: 1–18 years). Seventy-eight provided information about the personal reason for immigration: 37 (47.4%) had joined family already living in Germany, 13 (16.7%) were asylum seekers, 12 (15.4%) had immigrated as guest workers, 9 (11.5%) were guest or exchange students, 6 (7.7%) had a status of late repatriates, and one (1.3%) was au-pair. Of 80 first generation migrants providing information, twenty-three (28.8%) reported to visit their home country at least once a year, 26 (32.5%) less than once a year, and 31 (38.8%) had not been visiting their home country since immigration.

Bottom Line: When combining information from the standard notification variables country of birth and citizenship, the sensitivity to detect second generation migration was 28.6%.This may be explained by presumably frequent contact and transmission within migrant populations.Second generation migration is insufficiently captured by the surveillance variables country of birth and citizenship.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Pneumology and Immunology, Charité -Universitätsmedizin, Berlin, Germany; Division of Global Health Equity, Brigham and Women's Hospital and Harvard Medical School, Boston, United States of America.

ABSTRACT

Background: In Western Europe, migrants constitute an important risk group for tuberculosis, but little is known about successive generations of migrants. We aimed to characterize migration among tuberculosis cases in Berlin and to estimate annual rates of tuberculosis in two subsequent migrant generations. We hypothesized that second generation migrants born in Germany are at higher risk of tuberculosis compared to native (non-migrant) residents.

Methods: A prospective cross-sectional study was conducted. All tuberculosis cases reported to health authorities in Berlin between 11/2010 and 10/2011 were eligible. Interviews were conducted using a structured questionnaire including demographic data, migration history of patients and their parents, and language use. Tuberculosis rates were estimated using 2011 census data.

Results: Of 314 tuberculosis cases reported, 154 (49.0%) participated. Of these, 81 (52.6%) were first-, 14 (9.1%) were second generation migrants, and 59 (38.3%) were native residents. The tuberculosis rate per 100,000 individuals was 28.3 (95CI: 24.0-32.6) in first-, 10.2 (95%CI: 6.1-16.6) in second generation migrants, and 4.6 (95%CI: 3.7-5.6) in native residents. When combining information from the standard notification variables country of birth and citizenship, the sensitivity to detect second generation migration was 28.6%.

Conclusions: There is a higher rate of tuberculosis among second generation migrants compared to native residents in Berlin. This may be explained by presumably frequent contact and transmission within migrant populations. Second generation migration is insufficiently captured by the surveillance variables country of birth and citizenship. Surveillance systems in Western Europe should allow for quantifying the tuberculosis burden in this important risk group.

No MeSH data available.


Related in: MedlinePlus