移民和旅行者中的潜伏性和活动性结核感染：来自西班牙 +REDIVI 合作网络的回顾性分析。

Latent and active tuberculosis infections in migrants and travellers: A retrospective analysis from the Spanish +REDIVI collaborative network.

机构信息

Hospital General Universitario de Elda, Alicante, Spain.

National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramon y Cajal Hospital, IRYCIS, Madrid, Spain.

出版信息

Travel Med Infect Dis. 2020 Jul-Aug;36:101460. doi: 10.1016/j.tmaid.2019.07.016. Epub 2019 Jul 29.

DOI:10.1016/j.tmaid.2019.07.016

PMID:31369899

Abstract

BACKGROUND

Tuberculosis (TB) is the leading cause of infectious disease mortality worldwide. We analysed active and latent TB infections (LTBI) from the Spanish Network for the Study of Imported Infectious Diseases by Travellers and Immigrants (+REDIVI).

METHODS

Observational, retrospective, multicentre study of TB and LTBI registered in the +REDIVI network from October 2009 to December 2016.

RESULTS

Of 1008 cases of LTBI, 884 (87.7%) were immigrants; 93 (4.5%), immigrants visiting friends and relatives (VFR); 2 (0.9%), VFR-travellers; and 29 (1.1%), travellers. Absolute (N = 157 vs. N = 75) and relative (12.5% vs. 5.9%) frequency decreased over the study period (p = 0.003). Median time to diagnosis was 24.6 months (females 50.3 vs males 11.9; p < 0.001). Of 448 TB cases, 405 (90.4%) were in immigrants; 30 (6.7%), VFR-immigrants; 6 (1.3%), VFR-travellers; and 7 (1.6%), travellers. Median time to diagnosis was 62.5 months (females 86.6 vs males 70.1; p = 0.0075). There were 8 multidrug resistant TB cases and 1 extensively drug resistant case of TB, all in immigrants.

CONCLUSION

TB was frequently diagnosed more than 5 years after arrival in Spain. Screening programmes for TB and LTBI in immigrants should be considered beyond this time point. Women showed a higher diagnostic delay for both latent and active TB.

摘要

背景

结核病（TB）是全球传染病死亡的主要原因。我们分析了西班牙旅行者和移民感染性疾病研究网络（+REDIVI）中的活动性和潜伏性结核感染（LTBI）。

方法

这是一项观察性、回顾性、多中心研究，对 2009 年 10 月至 2016 年 12 月期间+REDIVI 网络中登记的结核和 LTBI 病例进行了分析。

结果

在 1008 例 LTBI 中，884 例（87.7%）为移民；93 例（4.5%）为探亲访友旅行者（VFR）；2 例（0.9%）为 VFR-旅行者；29 例（1.1%）为旅行者。绝对（N=157 例比 N=75 例）和相对（12.5%比 5.9%）频率在研究期间下降（p=0.003）。诊断中位时间为 24.6 个月（女性 50.3 个月比男性 11.9 个月；p<0.001）。在 448 例结核病例中，405 例（90.4%）为移民；30 例（6.7%）为 VFR-移民；6 例（1.3%）为 VFR-旅行者；7 例（1.6%）为旅行者。诊断中位时间为 62.5 个月（女性 86.6 个月比男性 70.1 个月；p=0.0075）。有 8 例耐多药结核病例和 1 例广泛耐药结核病例，均为移民。