2000-2018 年托斯卡纳地区移民与本地居民、成年与儿童的结核病负担。

Tuberculosis burden in immigrants and natives, adults and children, in Tuscany between 2000-2018.

机构信息

Anna Meyer Children's University Hospital, Department of Sciences for Health Sciences, University of Florence, Viale Pieraccini, 24, 50100, Florence, Italy.

Tuscany Regional Government Department of Right to Health and Solidarity Policies, Information Technology Section, Via T. Alderotti 26/n, 50123, Florence, Italy.

出版信息

Travel Med Infect Dis. 2021 Nov-Dec;44:102185. doi: 10.1016/j.tmaid.2021.102185. Epub 2021 Oct 29.

DOI:10.1016/j.tmaid.2021.102185

PMID:34715364

Abstract

BACKGROUND

Updated data on epidemiology of tuberculosis are needed in Italy. The aim of this study is to evaluate trends in incidence and associated lethality of tuberculosis in immigrants compared with Italians.

METHODS

All tuberculosis cases diagnosed from 2000 to 2018 in 31 Tuscan hospitals were retrospectively identified.

RESULTS

In 10,827 tuberculosis cases 6715 were males (62%), 4312 (60%) were Italian-born. Hospitalization rate was 15.37/100,000 population/year. The most common comorbidity were liver disease (832/10,827; 7.7%), COPD (675/10,827; 6.2%), cancer (614/10,827; 5.7%). HIV was more frequent in the immigrants (p < 0.001). Extra-pulmonary tuberculosis cases (EPTB) were mainly localized in pleura (740/3,894, 19%) and lymph nodes (449/3,894, 11,5%). HIV was associated with an increased risk of EPTB (OR 3.51 95% CI 2.92-4.23, p < 0.0001). EPTB risk was increased in South Asian-born patients (OR 1.77, 95% CI 1.46-2.15, p < 0.0001) as well in African-born patients (OR 1.13, 95% CI 1.03-1.24, p = 0.0091), who were at risk for gastroenteric tuberculosis (OR 3.74, 95% CI 2.69-5.22, p < 0.0001). Overall mortality rate was 0.006 per 1000. Most of death cases (89%) were Italians (p < 0.02) and mainly affected by pulmonary tuberculosis (PTB).

CONCLUSIONS

In Tuscany, tuberculosis is still a health concern in terms of both morbidity and mortality.

摘要

背景

意大利需要结核病流行病学的最新数据。本研究旨在评估与意大利人相比，移民结核病的发病率和相关死亡率趋势。

方法

回顾性分析了 2000 年至 2018 年在托斯卡纳 31 家医院诊断的所有结核病病例。

结果

在 10827 例结核病病例中，男性 6715 例（62%），意大利出生者 4312 例（60%）。住院率为 15.37/100000 人/年。最常见的合并症是肝病（832/10827；7.7%）、COPD（675/10827；6.2%）、癌症（614/10827；5.7%）。HIV 在移民中更为常见（p<0.001）。肺外结核病（EPTB）主要定位于胸膜（740/3894，19%）和淋巴结（449/3894，11.5%）。HIV 与 EPTB 的风险增加相关（OR 3.51，95%CI 2.92-4.23，p<0.0001）。南亚出生的患者（OR 1.77，95%CI 1.46-2.15，p<0.0001）和非洲出生的患者（OR 1.13，95%CI 1.03-1.24，p=0.0091）EPTB 的风险增加，他们易患胃肠道结核病（OR 3.74，95%CI 2.69-5.22，p<0.0001）。总体死亡率为 0.006/1000。大多数死亡病例（89%）为意大利人（p<0.02），主要受肺结核（PTB）影响。