TY - JOUR
T1 - Tuberculosis transmission patterns among Spanish-born and foreign-born populations in the city of Barcelona
AU - Borrell, S.
AU - Español, M.
AU - Orcau, À
AU - Tudó, G.
AU - March, F.
AU - Caylà, J. A.
AU - Jansà, J. M.
AU - Alcaide, F.
AU - Martín-Casabona, N.
AU - Salvadó, M.
AU - Martinez, J. A.
AU - Vidal, R.
AU - Sanchez, F.
AU - Altet, N.
AU - Rey, E.
AU - Coll, P.
AU - González-Martín, J.
N1 - Funding Information:
This study was financed by grants from the Fondo de Investigaciones Sanitarias (02/1489, 02/0348, 04/2381), a grant from la Fundació La Marató de TV3 and was supported by Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III and the Spanish Network for the Research in Infectious Diseases (REIPI RD06/0008) and CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III. S.B. received a grant of Formation in Research and Teaching (BRD) from the University of Barcelona. The authors have no commercial affiliations, funding sources or conflict of interests to declare.
PY - 2010/6
Y1 - 2010/6
N2 - During a 2-year period (2003-2004), tuberculosis (TB) transmission in Barcelona and the factors related to transmission among the Spanish- and foreign-born populations were studied by molecular epidemiology. Data were obtained from TB cases and Conventional Contact Tracing registries and genotyping was performed using restriction fragment length polymorphism (RFLP)-IS. 6110 and MIRU12 as a secondary typing method. Of the 892 TB cases reported, 583 (65.3%) corresponded to Spanish-born and 309 (34.6%) to foreign-born. Six hundred and eighty-seven cases (77%) were confirmed by culture. RFLP typing of 463/687 (67.4%) isolates was performed, revealing 280 (60.5%) unique and 183 (39.5%) shared patterns, which were grouped into 65 clusters. Spanish-born individuals were significantly more clustered than foreign-born individuals (44.6% vs. 28.8%; p 0.016). Clustering in foreign-born individuals was associated with HIV (p 0.051, odds ratio = 3.1, 95% confidence interval 1-10.9) and alcohol abuse (p 0.022), whereas, in the Spanish-born individuals, clustering was associated with age in the range 21-50 years, (p 0.024). Of the total clusters, 36/65 (55.3%) included only Spanish-born patients, whereas 22/65 (33.8%) included individuals from both populations. In mixed clusters, the index case was Spanish-born in 53% and foreign-born in 47%. Among the foreign-born, 2.8% were ill on arrival, 30% developed TB within the first year and 50.3% developed TB within the first 2 years; 58.3% were from South America. In conclusion, half of the foreign-born TB patients developed the disease during the first 2 years after arrival, which, in most cases, was the result of endogenous reactivation. Recent TB transmission among Spanish-born and foreign-born populations, as well as bidirectional transmission between communities, contributed significantly to the burden of TB in Barcelona, suggesting the need to improve Public Health interventions in both populations.
AB - During a 2-year period (2003-2004), tuberculosis (TB) transmission in Barcelona and the factors related to transmission among the Spanish- and foreign-born populations were studied by molecular epidemiology. Data were obtained from TB cases and Conventional Contact Tracing registries and genotyping was performed using restriction fragment length polymorphism (RFLP)-IS. 6110 and MIRU12 as a secondary typing method. Of the 892 TB cases reported, 583 (65.3%) corresponded to Spanish-born and 309 (34.6%) to foreign-born. Six hundred and eighty-seven cases (77%) were confirmed by culture. RFLP typing of 463/687 (67.4%) isolates was performed, revealing 280 (60.5%) unique and 183 (39.5%) shared patterns, which were grouped into 65 clusters. Spanish-born individuals were significantly more clustered than foreign-born individuals (44.6% vs. 28.8%; p 0.016). Clustering in foreign-born individuals was associated with HIV (p 0.051, odds ratio = 3.1, 95% confidence interval 1-10.9) and alcohol abuse (p 0.022), whereas, in the Spanish-born individuals, clustering was associated with age in the range 21-50 years, (p 0.024). Of the total clusters, 36/65 (55.3%) included only Spanish-born patients, whereas 22/65 (33.8%) included individuals from both populations. In mixed clusters, the index case was Spanish-born in 53% and foreign-born in 47%. Among the foreign-born, 2.8% were ill on arrival, 30% developed TB within the first year and 50.3% developed TB within the first 2 years; 58.3% were from South America. In conclusion, half of the foreign-born TB patients developed the disease during the first 2 years after arrival, which, in most cases, was the result of endogenous reactivation. Recent TB transmission among Spanish-born and foreign-born populations, as well as bidirectional transmission between communities, contributed significantly to the burden of TB in Barcelona, suggesting the need to improve Public Health interventions in both populations.
KW - Immigration
KW - Molecular epidemiology
KW - Native-born
KW - Transmission
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=77953947357&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953947357&partnerID=8YFLogxK
U2 - 10.1111/j.1469-0691.2009.02886.x
DO - 10.1111/j.1469-0691.2009.02886.x
M3 - Article
C2 - 19681961
AN - SCOPUS:77953947357
SN - 1198-743X
VL - 16
SP - 568
EP - 574
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 6
ER -