Background

Tuberculosis (TB) is the leading cause of infectious disease mortality worldwide. We analysed active and latent TB infections (LTBI) from the Spanish Network for the Study of Imported Infectious Diseases by Travellers and Immigrants (+REDIVI).

Methods

Observational, retrospective, multicentre study of TB and LTBI registered in the +REDIVI network from October 2009 to December 2016.

Results

Of 1008 cases of LTBI, 884 (87.7%) were immigrants; 93 (4.5%), immigrants visiting friends and relatives (VFR); 2 (0.9%), VFR-travellers; and 29 (1.1%), travellers. Absolute (N = 157 vs. N = 75) and relative (12.5% vs. 5.9%) frequency decreased over the study period (p = 0.003). Median time to diagnosis was 24.6 months (females 50.3 vs males 11.9; p < 0.001).

Of 448 TB cases, 405 (90.4%) were in immigrants; 30 (6.7%), VFR-immigrants; 6 (1.3%), VFR-travellers; and 7 (1.6%), travellers. Median time to diagnosis was 62.5 months (females 86.6 vs males 70.1; p = 0.0075).

There were 8 multidrug resistant TB cases and 1 extensively drug resistant case of TB, all in immigrants.

Conclusion

TB was frequently diagnosed more than 5 years after arrival in Spain. Screening programmes for TB and LTBI in immigrants should be considered beyond this time point. Women showed a higher diagnostic delay for both latent and active TB.

中文翻译：

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移民和旅行者的潜伏性和活动性结核病感染：西班牙 +REDIVI 合作网络的回顾性分析。

背景

结核病 (TB) 是全球传染病死亡的主要原因。我们分析了来自西班牙旅行者和移民输入传染病研究网络 (+REDIVI) 的活动性和潜伏性结核病感染 (LTBI)。

方法

2009 年 10 月至 2016 年 12 月在 +REDIVI 网络中注册的 TB 和 LTBI 的观察性、回顾性、多中心研究。

结果

在 1008 例 LTBI 病例中，884 例（87.7%）是移民；93（4.5%），移民探亲访友（VFR）；2 (0.9%), VFR-travelers; 和 29 (1.1%)，旅行者。绝对（N = 157 vs. N = 75）和相对（12.5% vs. 5.9%）频率在研究期间下降（p = 0.003）。诊断的中位时间为 24.6 个月（女性 50.3 对男性 11.9；p < 0.001）。

在 448 例结核病例中，405 例（90.4%）是移民；30 (6.7%)，VFR 移民；6 (1.3%)，VFR 旅行者；和 7 (1.6%)，旅行者。诊断的中位时间为 62.5 个月（女性 86.6 对男性 70.1；p = 0.0075）。

耐多药结核病8例，广泛耐药结核病1例，均为移民。

结论

TB 在抵达西班牙 5 年后经常被诊断出来。应考虑在此时间点之后对移民进行 TB 和 LTBI 筛查计划。女性对潜伏性和活动性结核病的诊断延迟更高。