Epidemiology and Infection

Impact of immigration and HIV infection on tuberculosis incidence in an area of low tuberculosis prevalence

a1 Cancer Epidemiology Unit, CPO Piemonte, CeRMS, University of Turin, Italy
a2 Tuberculosis Prevention Service, Local Health Unit 4, Turin, Italy
a3 Department of Public Health and Microbiology, University of Turin, Italy
a4 Epidemiology Unit, Local Health Unit 20, Alessandria, Italy

Article author query
baussano i   [PubMed][Google Scholar] 
bugiani m   [PubMed][Google Scholar] 
gregori d   [PubMed][Google Scholar] 
pasqualini c   [PubMed][Google Scholar] 
demicheli v   [PubMed][Google Scholar] 
merletti f   [PubMed][Google Scholar] 


The aim of this study is to assess the effects of immigration from countries with a high prevalence of tuberculosis (HPCs), of HIV/AIDS prevalence, and the ageing of the indigenous population, on tuberculosis distribution in a low-prevalence area (LPCs), the Piedmont Region of Italy. Tuberculosis incidence and HIV cases were identified by linking records from the surveillance systems. Overall, 640 tuberculosis cases were identified and crude annual incidence was found to be 17·3/100000. The incidence rate ratio for HIV infection as a risk factor for tuberculosis (11·4 and 51·9 among individuals from HPCs and LPCs respectively) was greater than that for immigration from HPCs (6·7 and 30·9 among HIV+ and HIV− individuals). Immigration accounted for a larger number of incident cases [population attributable risk % (PAR %): 31·8 and 52·8% among HIV+ and HIV− individuals] than did HIV infection (PAR %: 5·4 and 11·1% among individuals from HPCs and LPCs). Efforts should be made to identify and treat young immigrants from HPCs.

(Accepted March 1 2006)
(Published Online April 20 2006)

c1 Università di Torino – Cancer Epidemiology Unit, Via Santena 7, 10126 Torino, Italy. (Email: iacopo.baussano@unito.it)