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Ongoing tuberculosis transmission among second-generation Ethiopian immigrants
H Bishara1,2, M Green2, D Chemtob3,4
1Pulmonary Division and Tuberculosis Center, Galilee Medical Center, Nahariya, and Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel.
Epidemiology and Infection
|August 4, 2020
Summary
An outbreak of tuberculosis (TB) occurred in Israel, spreading among second-generation Ethiopian immigrants and native Israelis. Poor treatment completion for latent TB infection (LTBI) hindered control efforts.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Tuberculosis (TB) control efforts among Ethiopian immigrants in Israel have faced challenges.
- A significant TB outbreak involving second-generation Ethiopian immigrants and native Israelis occurred from 2011 to 2019.
Purpose of the Study:
- To report on a specific TB outbreak in Israel.
- To analyze patient and health system barriers contributing to the outbreak's propagation.
- To highlight challenges in managing TB in vulnerable populations.
Main Methods:
- Retrospective analysis of TB cases and contact investigations.
- Genotyping of Mycobacterium tuberculosis strains.
- Review of screening and latent TB infection (LTBI) treatment completion rates.
Main Results:
- The outbreak involved 13 culture-positive TB patients, with an additional 36 cases identified through genotyping.
- Contact investigation showed low LTBI treatment completion rates (16.9% of those recommended).
- Failure to complete LTBI treatment led to disease progression in some contacts.
Conclusions:
- Routine contact investigation and treatment practices were insufficient to contain this TB outbreak.
- Significant barriers to care exist for vulnerable populations, hindering effective TB control.
- Identifying high-risk groups and addressing these barriers are crucial for future TB prevention.
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