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Tuberculosis incidence in foreign-born people residing in European countries in 2020.

ABSTRACT: BackgroundEuropean-specific policies for tuberculosis (TB) elimination require identification of key populations that benefit from TB screening.AimWe aimed to identify groups of foreign-born individuals residing in European countries that benefit most from targeted TB prevention screening.MethodsThe Tuberculosis Network European Trials group collected, by cross-sectional survey, numbers of foreign-born TB patients residing in European Union (EU) countries, Iceland, Norway, Switzerland and the United Kingdom (UK) in 2020 from the 10 highest ranked countries of origin in terms of TB cases in each country of residence. Tuberculosis incidence rates (IRs) in countries of residence were compared with countries of origin.ResultsData on 9,116 foreign-born TB patients in 30 countries of residence were collected. Main countries of origin were Eritrea, India, Pakistan, Morocco, Romania and Somalia. Tuberculosis IRs were highest in patients of Eritrean and Somali origin in Greece and Malta (both > 1,000/100,000) and lowest among Ukrainian patients in Poland (3.6/100,000). They were mainly lower in countries of residence than countries of origin. However, IRs among Eritreans and Somalis in Greece and Malta were five times higher than in Eritrea and Somalia. Similarly, IRs among Eritreans in Germany, the Netherlands and the UK were four times higher than in Eritrea.ConclusionsCountry of origin TB IR is an insufficient indicator when targeting foreign-born populations for active case finding or TB prevention policies in the countries covered here. Elimination strategies should be informed by regularly collected country-specific data to address rapidly changing epidemiology and associated risks.

SUBMITTER: Vasiliu A

PROVIDER: S-EPMC10588305 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Tuberculosis incidence in foreign-born people residing in European countries in 2020.

Vasiliu Anca A Köhler Niklas N Altpeter Ekkehardt E Ægisdóttir Tinna Rán TR Amerali Marina M de Oñate Wouter Arrazola WA Bakos Ágnes Á D'Amato Stefania S Cirillo Daniela Maria DM van Crevel Reinout R Davidaviciene Edita E Demuth Irène I Domínguez Jose J Duarte Raquel R Günther Gunar G Guthmann Jean-Paul JP Hatzianastasiou Sophia S Holm Louise Hedevang LH Herrador Zaida Z Hribar Urška U Huberty Conny C Ibraim Elmira E Jackson Sarah S Jensenius Mogens M Josefsdottir Kamilla Sigridur KS Koch Anders A Korzeniewska-Kosela Maria M Kuksa Liga L Kunst Heinke H Lienhardt Christian C Mahler Beatrice B Makek Mateja Janković MJ Muylle Inge I Normark Johan J Pace-Asciak Analita A Petrović Goranka G Pieridou Despo D Russo Giulia G Rzhepishevska Olena O Salzer Helmut J F HJF Marques Marta Sá MS Schmid Daniela D Solovic Ivan I Sukholytka Mariya M Svetina Petra P Tyufekchieva Mariya M Vasankari Tuula T Viiklepp Piret P Villand Kersti K Wallenfels Jiri J Wesolowski Stefan S Mandalakas Anna-Maria AM Martinez Leonardo L Zenner Dominik D Lange Christoph C

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 20231001 42

BackgroundEuropean-specific policies for tuberculosis (TB) elimination require identification of key populations that benefit from TB screening.AimWe aimed to identify groups of foreign-born individuals residing in European countries that benefit most from targeted TB prevention screening.MethodsThe Tuberculosis Network European Trials group collected, by cross-sectional survey, numbers of foreign-born TB patients residing in European Union (EU) countries, Iceland, Norway, Switzerland and the Un ...[more]

PMID: 37855907

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Project description:BackgroundThe current vaccine against tuberculosis, BCG, is effective when given in most TB-endemic countries at birth but has diminished efficacy against pulmonary TB after 15-20 years. As a result, new booster vaccines for adolescents and adults are being developed to realize the World Health Organization target of global elimination of TB by 2035. Multiple TB candidates thus are in active clinical development.MethodsOne of these, DAR-901, is advancing in human clinical trials. These clinical trials are conducted in BCG immunized adults with and without HIV infection in order to assess safety and efficacy among the people most in need of a new vaccine. A Phase I dose escalation trial of DAR-901 in BCG-immunized adults with or without HIV infection was conducted between 2014 and 2016. This offered an unusual opportunity to qualitatively examine why foreign-born adults living in the United States - a poorly studied population - decide to participate, or not, in clinical trials.ResultsWe conducted a qualitative study of individuals who were recruited to participate in this Phase I vaccine trial, interviewing those who agreed and declined to participate. We found diverse motivations for participation or refusal; varied understandings of tuberculosis and vaccines; and complex views about how 'informed consent' can be at odds with cultural understandings of power, authority, and medical decision-making. These dynamics included: knowledge (direct or indirect) of tuberculosis, a desire to be altruistic and simultaneous hopes for personal gain as well as concerns over what remuneration for participation could mean, the importance of personal relationships with care providers in shaping volunteerism, concerns over privacy, and evidence of how culture and history shape medical decision-making.ConclusionsThis US-based trial, aimed at addressing a crucible global health issue, raises productive questions about the interface between altruism and scepticism regarding clinical research participation.Trial registrationNCT02063555 .

Dataset Information

Tuberculosis incidence in foreign-born people residing in European countries in 2020.

Publications

Tuberculosis incidence in foreign-born people residing in European countries in 2020.

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