Faculty of Medicine & Health Sciences, University of Nottingham, UK.
Migrant Health Research Group, Institute for Infection and Immunity, St George's Hospital University of London, UK.
Public Health. 2024 Aug;233:100-107. doi: 10.1016/j.puhe.2024.04.001. Epub 2024 Jun 11.
The burden of tuberculosis (TB) in migrant children and young people (CYP) is commonly overlooked, despite the increasing incidence of TB in migrant populations in the European region. This study aimed to examine the distribution and disease characteristics of TB among migrant and native-born CYP through analysis of data from the European Centre for Disease Prevention and Control (ECDC) surveillance system (TESSy).
Retrospective database analysis.
A retrospective database analysis was conducted on all CYP TB cases (0-17 years) reported to TESSy (1995-2017), exploring distribution, site of TB, and presence of MDR-TB using multivariate analysis in R statistical software.
Of the 73,176 CYP TB cases reported in the EU/EFTA (1995-2017), 24.4% (n = 17,879) occurred in migrant CYP and 75.6% (n = 55,297) occurred in native-born CYP. Migrant CYP were more likely (P < 0.001) to have pulmonary TB (OR: 1.90; 95% CI: 1.74-2.09) and unsuccessful treatment outcomes (OR: 2.05; 95% CI: 1.74-2.40) compared to native-born CYP. The proportion of extrapulmonary TB, compared to pulmonary TB across total CYP cases was higher than the existing evidence base.
Overall, there were significant differences in the site of TB and treatment outcomes between migrant and native-born CYP. To improve outcomes, TB screening and detection practices should focus on facilitating care in migrant CYP. However, to better understand the implications of these findings on broader TB control, TB among CYP should be addressed more frequently in reports and research.
结核病（TB）在移民儿童和青少年（CYP）中的负担通常被忽视，尽管欧洲地区移民人群中的 TB 发病率不断上升。本研究旨在通过分析欧洲疾病预防控制中心（ECDC）监测系统（TESSy）的数据，研究移民和本地出生的 CYP 中 TB 的分布和疾病特征。
回顾性数据库分析。
对 TESSy（1995-2017 年）报告的所有 CYP TB 病例（0-17 岁）进行回顾性数据库分析，使用 R 统计软件中的多变量分析探讨分布、TB 部位和耐多药 TB 的存在。
在欧盟/欧洲自由贸易区（1995-2017 年）报告的 73176 例 CYP TB 病例中，24.4%（n=17879）发生在移民 CYP 中，75.6%（n=55297）发生在本地出生的 CYP 中。与本地出生的 CYP 相比，移民 CYP 更有可能（P<0.001）患有肺结核（OR：1.90；95%CI：1.74-2.09）和治疗结果不成功（OR：2.05；95%CI：1.74-2.40）。与肺外 TB 相比，在总 CYP 病例中，肺外 TB 的比例高于现有证据基础。
总体而言，移民和本地出生的 CYP 之间在 TB 部位和治疗结果方面存在显著差异。为了改善结果，TB 筛查和检测实践应侧重于促进移民 CYP 的护理。然而，为了更好地理解这些发现对更广泛的 TB 控制的影响，应该更频繁地在报告和研究中解决 CYP 中的 TB 问题。
