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

Published online by Cambridge University Press:  20 April 2006

I. BAUSSANO
Affiliation:
Cancer Epidemiology Unit, CPO Piemonte, CeRMS, University of Turin, Italy
M. BUGIANI
Affiliation:
Tuberculosis Prevention Service, Local Health Unit 4, Turin, Italy
D. GREGORI
Affiliation:
Department of Public Health and Microbiology, University of Turin, Italy
C. PASQUALINI
Affiliation:
Epidemiology Unit, Local Health Unit 20, Alessandria, Italy
V. DEMICHELI
Affiliation:
Epidemiology Unit, Local Health Unit 20, Alessandria, Italy
F. MERLETTI
Affiliation:
Cancer Epidemiology Unit, CPO Piemonte, CeRMS, University of Turin, Italy
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Abstract

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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.

Type
Research Article
Copyright
2006 Cambridge University Press