Immigrants and tuberculosis in Hong Kong.

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• Tuberculosis (TB) remains a significant global health challenge.
• Immigration patterns can influence the epidemiology of infectious diseases within host countries.

Purpose of the Study:

• To investigate the impact of immigrant populations on tuberculosis epidemiology in Hong Kong.
• To analyze TB incidence, drug resistance, treatment outcomes, and relapse rates among different immigrant groups.

Main Methods:

• A longitudinal cohort study design was employed in Hong Kong.
• Data on TB notifications, socio-demographics, and treatment outcomes were collected from 2006 to 2013.
• Sex- and age-standardized incidence ratios were calculated by place of birth, and factors associated with drug resistance and poor outcomes were analyzed.

Main Results:

• Higher TB incidence rates were observed in various immigrant groups compared to the local population.
• Immigrants from Mainland China, India, Pakistan, Bangladesh, the Philippines, Thailand, Indonesia, Nepal, and Vietnam showed elevated incidence ratios.
• Factors such as younger age, birth in specific Asian countries, and prior treatment were linked to drug resistance. Older age, non-permanent residency, and drug resistance were associated with poorer treatment outcomes. Birth outside Hong Kong predicted higher relapse rates.

Conclusions:

• Immigrants contribute to a higher burden of tuberculosis, including increased drug resistance, in Hong Kong.
• The findings raise concerns about the potential for secondary transmission of drug-resistant TB within the local community.
• Targeted public health strategies are needed to address TB control among immigrant populations.