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Persistent risk of tuberculosis in migrants a decade after arrival in Australia
Author(s) -
McPherson Michelle E,
Kelly Heath,
Patel Mahomed S,
Leslie David
Publication year - 2008
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2008.tb01768.x
Subject(s) - medicine , demography , tuberculosis , incidence (geometry) , european union , odds ratio , european region , arrival time , epidemiology , pediatrics , multivariate analysis , geography , physics , engineering , regional science , sociology , transport engineering , optics , business , economic policy , pathology
Objective: To examine the risk of tuberculosis (TB) in migrants a decade after their arrival in Australia. Design, setting and patients: Retrospective review of laboratory‐confirmed cases of TB in migrants diagnosed between 1990 and 2004 by the state TB reference laboratory in Victoria, analysed by a multivariate model comparing migrants diagnosed 10 or more years after arrival with those diagnosed within 10 years of arrival. Main outcome measures: Time to diagnosis; characteristics of migrants diagnosed with TB, including age, sex, region of birth, site of infection, and drug resistance. Results: A third of migrants (734/1924) were diagnosed with TB 10 or more years after arrival in Australia. This group was more likely to be European‐born (adjusted odds ratio [AOR], 3.4; 95% CI, 2.4–5.0) and older than 34 years (35–49 years: AOR, 3.8; 95% CI, 2.0–7.0), reflecting the longer time European migrants have been in Australia. There were two distinct European groups: European Union (EU)/Western and Central/Eastern. The Central/Eastern group were from countries with current high TB rates and, compared with the EU/Western group, were younger (mean age, 50 v 64 years) and more likely to be diagnosed within 10 years of arrival (47% v 14%; P < 0.001). Conclusion: European migrants were more likely to be diagnosed a decade or more after arrival in Australia. Once migrants from the currently high TB incidence areas of Asia and Africa have been in Australia for a similar period of time, their timing of diagnosis may resemble that for migrants from Europe. The current screening policy should be complemented with more sensitive techniques to detect latent TB.