Human Tuberculosis in Migrant and Autocthonous Patients: A Ten-Year Single-Centre Experience

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• Global migratory movements are increasing, impacting disease epidemiology.
• Tuberculosis (TB) remains a significant public health concern, particularly in diverse populations.
• Understanding TB presentation and outcomes in migrant versus autochthonous populations is crucial for effective control.

Purpose of the Study:

• To compare tuberculosis cases between migrant and autochthonous patients in a specific health district.
• To identify factors associated with unfavorable treatment outcomes in TB patients.
• To assess the impact of migration on TB epidemiology and patient management.

Main Methods:

• Retrospective analytical cohort study.
• Analysis of 98 patients diagnosed with tuberculosis between 2013 and 2023 in Elda Health District, Spain.
• Comparison of demographic data, clinical presentation, treatment outcomes, and risk factors between migrant and autochthonous groups.

Main Results:

• Migrants represented 29.6% of TB cases, were younger, predominantly male, and had fewer comorbidities and lower substance use rates.
• Pulmonary TB was prevalent in 82% of both groups; nine cases of drug-resistant TB were identified.
• No significant differences in cure rates, mortality, or hospitalization were observed between groups.
• Unfavorable outcomes (mortality, treatment failure, loss to follow-up) were more frequent in males and patients with elevated C-reactive protein (CRP) or a higher CRP/albumin ratio (p=0.033).
• Migrants showed a non-significant trend toward higher loss to follow-up and drug resistance.

Conclusions:

• Migrants constitute a significant portion of tuberculosis cases and present with distinct demographic profiles.
• While overall treatment outcomes were similar, specific factors like elevated CRP levels and male sex are associated with unfavorable outcomes.
• Further research into targeted interventions for high-risk groups, including migrants, is warranted to improve TB management and reduce unfavorable outcomes.