Risk of active tuberculosis in immigrants: effects of age, region of origin and time since arrival in a low-exposure setting

McBryde, Emma S., and Denholm, Justin T. (2012) Risk of active tuberculosis in immigrants: effects of age, region of origin and time since arrival in a low-exposure setting. Medical Journal of Australia, 197 (8). pp. 458-461.

[img] PDF (Published Version) - Published Version
Restricted to Repository staff only

View at Publisher Website: http://dx.doi.org/10.5694/mja12.10035
 
21
4


Abstract

Objective: To estimate the risk of active tuberculosis (TB) in immigrants to Victoria, Australia, as a function of time since arrival and stratified by age group and region of origin.

Design, setting and subjects: Longitudinal study of the incidence of active TB in Victorian immigrants, excluding New Zealanders, who arrived in Australia between 1975 and 2007. Victorian immigration data were used to describe annual arrival cohorts by age and region of origin, and TB case notification data for 1995 to 2010 were matched to the cohorts. Survival analysis was performed to determine incidence rates of active TB.

Main outcome measures: Incidence of active TB, stratified by age, region of origin and time since arrival in Australia.

Results: Incidence of active TB following immigration to Australia was highly dependent on region of origin, with the highest risks being in immigrants from South Asia and sub-Saharan Africa. For immigrants from high-risk regions (Asia, Africa and the Pacific), the incidence of active TB infection was 100–150 per 100 000 person-years in the first 6 years following immigration. Overall, we estimate that 50% of TB occurred within 7 years of arrival. A bimodal age distribution was evident, with peaks of incidence in 20–24-year-olds and 70–74-year-olds.

Conclusions: Our data show that substantial risk of TB in Victorian immigrants persists well beyond the first 2–3 years following arrival, and that risk is highly dependent on region of origin. The regional dependence suggests that public health strategies would benefit from more refined regional stratification of risk, which could be used to determine risk thresholds for the use of TB prevention strategies and predict rates of TB in Australia following particular patterns of immigration.

Item ID: 39755
Item Type: Article (Research - C1)
ISSN: 1326-5377
Funders: National Health and Medical Research Council of Australia (NHMRC)
Date Deposited: 09 Sep 2015 03:45
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 40%
16 STUDIES IN HUMAN SOCIETY > 1605 Policy and Administration > 160508 Health Policy @ 20%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 50%
92 HEALTH > 9202 Health and Support Services > 920207 Health Policy Evaluation @ 50%
Downloads: Total: 4
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page