Tuberculosis incidence in foreign-born people residing in European countries in 2020

Anca Vasiliu; Niklas Köhler; Ekkehardt Altpeter; Tinna Rán Ægisdóttir; Marina Amerali; Wouter Arrazola de Oñate; Ágnes Bakos; Stefania D’Amato; Daniela Maria Cirillo; Reinout van Crevel; Edita Davidaviciene; Irène Demuth; Jose Domínguez; Raquel Duarte; Gunar Günther; Jean-Paul Guthmann; Sophia Hatzianastasiou; Louise Hedevang Holm; Zaida Herrador; Urška Hribar; Conny Huberty; Elmira Ibraim; Sarah Jackson; Mogens Jensenius; Kamilla Sigridur Josefsdottir; Anders Koch; Maria Korzeniewska-Kosela; Liga Kuksa; Heinke Kunst; Christian Lienhardt; Beatrice Mahler; Mateja Janković Makek; Inge Muylle; Johan Normark; Analita Pace-Asciak; Goranka Petrović; Despo Pieridou; Giulia Russo; Olena Rzhepishevska; Helmut J.F. Salzer; Marta Sá Marques; Daniela Schmid; Ivan Solovic; Mariya Sukholytka; Petra Svetina; Mariya Tyufekchieva; Tuula Vasankari; Piret Viiklepp; Kersti Villand; Jiri Wallenfels; Stefan Wesolowski; Anna-Maria Mandalakas; Leonardo Martinez; Dominik Zenner; Christoph Lange; on behalf of the TBnet

doi:10.2807/1560-7917.ES.2023.28.42.2300051

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Tuberculosis incidence in foreign-born people residing in European countries in 2020
Anca Vasiliu^1,* , Niklas Köhler^2,3,4,* , Ekkehardt Altpeter⁵ , Tinna Rán Ægisdóttir⁶ , Marina Amerali⁷ , Wouter Arrazola de Oñate^8,9 , Ágnes Bakos¹⁰ , Stefania D’Amato¹¹ , Daniela Maria Cirillo¹² , Reinout van Crevel^13,14 , Edita Davidaviciene¹⁵ , Irène Demuth¹⁶ , Jose Domínguez¹⁷ , Raquel Duarte^18,19,20 , Gunar Günther^21,22 , Jean-Paul Guthmann²³ , Sophia Hatzianastasiou⁷ , Louise Hedevang Holm²⁴ , Zaida Herrador²⁵ , Urška Hribar²⁶ , Conny Huberty¹⁶ , Elmira Ibraim²⁷ , Sarah Jackson²⁸ , Mogens Jensenius²⁹ , Kamilla Sigridur Josefsdottir³⁰ , Anders Koch^24,31 , Maria Korzeniewska-Kosela³² , Liga Kuksa³³ , Heinke Kunst³⁴ , Christian Lienhardt^35,36 , Beatrice Mahler^27,37 , Mateja Janković Makek^38,39 , Inge Muylle⁴⁰ , Johan Normark^41,42 , Analita Pace-Asciak⁴³ , Goranka Petrović⁴⁴ , Despo Pieridou⁴⁵ , Giulia Russo¹² , Olena Rzhepishevska⁴⁶ , Helmut J.F. Salzer^47,48 , Marta Sá Marques²⁰ , Daniela Schmid⁴⁹ , Ivan Solovic^50,51 , Mariya Sukholytka⁵² , Petra Svetina⁵³ , Mariya Tyufekchieva⁵⁴ , Tuula Vasankari^55,56 , Piret Viiklepp⁵⁷ , Kersti Villand⁵⁷ , Jiri Wallenfels⁵⁸ , Stefan Wesolowski³² , Anna-Maria Mandalakas^1,2 , Leonardo Martinez⁵⁹ , Dominik Zenner^60,61 , Christoph Lange^1,2,3,4 , on behalf of the TBnet⁶²
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Affiliations: ¹ Baylor College of Medicine, Department of Pediatrics, Global and Immigrant Health, Global Tuberculosis Program, Houston, Texas, United States ² Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany ³ German Center for Infection Research (DZIF), TTU-TB, Borstel, Germany ⁴ Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany ⁵ Swiss Federal Office of Public Health, Division of Communicable Diseases, Bern, Switzerland ⁶ The National University Hospital of Iceland, Pharmaceutical Services, Reykjavik, Iceland ⁷ Tuberculosis Control Office, Department of Respiratory Infections, Directorate for Epidemiological Surveillance & Intervention, National Public Health Organization (NPHO), Athens, Greece ⁸ Belgian Lung and Tuberculosis Association, Brussels, Belgium ⁹ Flemish Association of Respiratory Health and TB Control, Leuven, Belgium ¹⁰ Koranyi National Institute for Pulmonology, Budapest, Hungary ¹¹ Prevention of Communicable Diseases and International Prophylaxis, General Direction of Health Prevention, Ministry of Health of Italy, Rome, Italy ¹² Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy ¹³ Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands ¹⁴ Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom ¹⁵ Vilnius University hospital Santaros Klinikos, Department of Tuberculosis State information system, Vilnius, Lithuania ¹⁶ Health Directorate of Luxembourg, Luxembourg ¹⁷ Institut d’Investigació Germans Trias i Pujol; Universitat Autònoma de Barcelona; CIBER Enfermedades Respiratorias; INNOVA4TB consortium Badalona, Barcelona, Spain ¹⁸ ICBAS – Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto ¹⁹ ISPUP – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal ²⁰ Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal ²¹ Department of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital, University of Bern, Switzerland ²² Department of Medical Sciences, School of Medicine, University of Namibia, Windhoek, Namibia ²³ Division of Infectious Diseases, Santé publique France, Saint-Maurice, France ²⁴ Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark ²⁵ Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain ²⁶ Tuberculosis Register of the Republic of Slovenia, University Clinic Golnik, Golnik, Slovenia ²⁷ Marius Nasta Institute of Pulmonology, Bucharest, Romania ²⁸ Infectious Diseases; Health Service Executive Health Protection Surveillance Centre, Dublin, Ireland ²⁹ Department of Infectious Diseases, Oslo University Hospital, Ullevaal, Norway ³⁰ Centre for Health Security and Communicable Disease Control, Directorate of Health, Iceland ³¹ Department of Infectious Diseases, Rigshospitalet University Hospital, Copenhagen, Denmark ³² Department of Tuberculosis Epidemiology and Surveillance, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland ³³ Riga East University Hospital, TB and Lung Disease Clinic, Riga, Latvia ³⁴ Blizard Institute, The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom ³⁵ Unité Unité Mixte Internationale 233 IRD – U1175 INSERM - Université de Montpellier, Institut de Recherche pour le Développement (IRD), Montpellier, France ³⁶ Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom ³⁷ Department Cardio-thoracic, Pneumophtisiology II, University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania ³⁸ University of Zagreb, School of Medicine Zagreb, Croatia ³⁹ University Hospital Centre Zagreb, Department for Lung diseases, Zagreb, Croatia ⁴⁰ Division of Pneumology, Onze-Lieve-Vrouw Ziekenhuis (OLV) Aalst, Aalst, Belgium ⁴¹ Department of Clinical Microbiology, Umeå University, Sweden ⁴² Wallenberg Centre for Molecular Medicine, Umeå University, Sweden ⁴³ Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Superintendence of Public Health, Ministry for Health of Malta, La Valetta, Malta ⁴⁴ Respiratory Diseases and Travel Medicine Department with Vaccination Unit, Infectious Diseases Epidemiology ServiceDepartment, Croatian Institute of Public Health, Zagreb, Croatia ⁴⁵ Cyprus National Reference Laboratory for Mycobacteria, Microbiology Department, Nicosia General Hospital, Nicosia, Cyprus ⁴⁶ Department of Chemistry, Department of Clinical Microbiology, Umeå University, Sweden ⁴⁷ Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine 4- Pneumology, Kepler University Hospital, Linz, Austria ⁴⁸ Faculty of Medicine, Johannes-Kepler-University, Linz, Austria and Ignaz Semmelweis Institut, Interuniversity Institute for Infection Resarch, Vienna, Austria ⁴⁹ Unit for Infectious Diseases Diagnostics and Infectious Diseases Epidemiology, Centre for Pathophysiology, Infectious Diseases and Immunology, Medical University of Vienna, Vienna, Austria ⁵⁰ National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy, Slovakia ⁵¹ Catholic University Ruzomberok, Ruzomberok, Slovakia ⁵² First Faculty of Medicine and Faculty Thomayer Hospital Prague, Czechia ⁵³ National TB Program and Tuberculosis Registry of Republic of Slovenia, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia ⁵⁴ Health Promotion and Prevention Unit, Directorate Public Health Protection and Health Control, Ministry of Health of Bulgaria, Sofia, Bulgaria ⁵⁵ University of Turku, Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku, Finland ⁵⁶ Finnish Lung Health Association (Filha ry), Helsinki, Finland ⁵⁷ Estonian Tuberculosis Register, Dept. of Registries, National Institute for Health Development, Tallinn, Estonia ⁵⁸ National TB Surveillance Unit, University Hospital Bulovka, Prague, Czechia ⁵⁹ Boston University, School of Public Health, Department of Epidemiology, Boston, Massachusetts, United States ⁶⁰ Global Public Health Unit, Wolfson Institute of Population Health Barts ⁶¹ The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom ⁶² The Tuberculosis Network European Trials Group (TBNET) (www.tbnet.eu)

* These authors contributed equally to this work and share first authorship.
Correspondence:
Christoph Lange
clange fz-borstel.de
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Citation style for this article: Vasiliu Anca, Köhler Niklas, Altpeter Ekkehardt, Ægisdóttir Tinna Rán, Amerali Marina, de Oñate Wouter Arrazola, Bakos Ágnes, D’Amato Stefania, Cirillo Daniela Maria, van Crevel Reinout, Davidaviciene Edita, Demuth Irène, Domínguez Jose, Duarte Raquel, Günther Gunar, Guthmann Jean-Paul, Hatzianastasiou Sophia, Holm Louise Hedevang, Herrador Zaida, Hribar Urška, Huberty Conny, Ibraim Elmira, Jackson Sarah, Jensenius Mogens, Josefsdottir Kamilla Sigridur, Koch Anders, Korzeniewska-Kosela Maria, Kuksa Liga, Kunst Heinke, Lienhardt Christian, Mahler Beatrice, Makek Mateja Janković, Muylle Inge, Normark Johan, Pace-Asciak Analita, Petrović Goranka, Pieridou Despo, Russo Giulia, Rzhepishevska Olena, Salzer Helmut J.F., Marques Marta Sá, Schmid Daniela, Solovic Ivan, Sukholytka Mariya, Svetina Petra, Tyufekchieva Mariya, Vasankari Tuula, Viiklepp Piret, Villand Kersti, Wallenfels Jiri, Wesolowski Stefan, Mandalakas Anna-Maria, Martinez Leonardo, Zenner Dominik, Lange Christoph, on behalf of the TBnet. Tuberculosis incidence in foreign-born people residing in European countries in 2020. Euro Surveill. 2023;28(42):pii=2300051. https://doi.org/10.2807/1560-7917.ES.2023.28.42.2300051 Received: 24 Jan 2023; Accepted: 12 May 2023

SDG 3: Tuberculosis

Abstract

Background

European-specific policies for tuberculosis (TB) elimination require identification of key populations that benefit from TB screening.

Aim

We aimed to identify groups of foreign-born individuals residing in European countries that benefit most from targeted TB prevention screening.

Methods

The Tuberculosis Network European Trials group collected, by cross-sectional survey, numbers of foreign-born TB patients residing in European Union (EU) countries, Iceland, Norway, Switzerland and the United Kingdom (UK) in 2020 from the 10 highest ranked countries of origin in terms of TB cases in each country of residence. Tuberculosis incidence rates (IRs) in countries of residence were compared with countries of origin.

Results

Data on 9,116 foreign-born TB patients in 30 countries of residence were collected. Main countries of origin were Eritrea, India, Pakistan, Morocco, Romania and Somalia. Tuberculosis IRs were highest in patients of Eritrean and Somali origin in Greece and Malta (both > 1,000/100,000) and lowest among Ukrainian patients in Poland (3.6/100,000). They were mainly lower in countries of residence than countries of origin. However, IRs among Eritreans and Somalis in Greece and Malta were five times higher than in Eritrea and Somalia. Similarly, IRs among Eritreans in Germany, the Netherlands and the UK were four times higher than in Eritrea.

Conclusions

Country of origin TB IR is an insufficient indicator when targeting foreign-born populations for active case finding or TB prevention policies in the countries covered here. Elimination strategies should be informed by regularly collected country-specific data to address rapidly changing epidemiology and associated risks.

This work is licensed under a Creative Commons Attribution 4.0 International License.

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Tuberculosis incidence in foreign-born people residing in European countries in 2020

Citation style for this article: <a href="/search?value1=Anca+Vasiliu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vasiliu Anca</a>, <a href="/search?value1=Niklas+K%C3%B6hler&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Köhler Niklas</a>, <a href="/search?value1=Ekkehardt+Altpeter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Altpeter Ekkehardt</a>, <a href="/search?value1=Tinna+R%C3%A1n+%C3%86gisd%C3%B3ttir&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ægisdóttir Tinna Rán</a>, <a href="/search?value1=Marina+Amerali&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Amerali Marina</a>, <a href="/search?value1=Wouter+Arrazola+de+O%C3%B1ate&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Oñate Wouter Arrazola</a>, <a href="/search?value1=%C3%81gnes+Bakos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bakos Ágnes</a>, <a href="/search?value1=Stefania+D%E2%80%99Amato&option1=author&noRedirect=true" class="nonDisambigAuthorLink">D’Amato Stefania</a>, <a href="/search?value1=Daniela+Maria+Cirillo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cirillo Daniela Maria</a>, <a href="/search?value1=Reinout+van+Crevel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Crevel Reinout</a>, <a href="/search?value1=Edita+Davidaviciene&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Davidaviciene Edita</a>, <a href="/search?value1=Ir%C3%A8ne+Demuth&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Demuth Irène</a>, <a href="/search?value1=Jose+Dom%C3%ADnguez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Domínguez Jose</a>, <a href="/search?value1=Raquel+Duarte&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Duarte Raquel</a>, <a href="/search?value1=Gunar+G%C3%BCnther&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Günther Gunar</a>, <a href="/search?value1=Jean-Paul+Guthmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Guthmann Jean-Paul</a>, <a href="/search?value1=Sophia+Hatzianastasiou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hatzianastasiou Sophia</a>, <a href="/search?value1=Louise+Hedevang+Holm&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Holm Louise Hedevang</a>, <a href="/search?value1=Zaida+Herrador&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Herrador Zaida</a>, <a href="/search?value1=Ur%C5%A1ka+Hribar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hribar Urška</a>, <a href="/search?value1=Conny+Huberty&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Huberty Conny</a>, <a href="/search?value1=Elmira+Ibraim&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ibraim Elmira</a>, <a href="/search?value1=Sarah+Jackson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jackson Sarah</a>, <a href="/search?value1=Mogens+Jensenius&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jensenius Mogens</a>, <a href="/search?value1=Kamilla+Sigridur+Josefsdottir&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Josefsdottir Kamilla Sigridur</a>, <a href="/search?value1=Anders+Koch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Koch Anders</a>, <a href="/search?value1=Maria+Korzeniewska-Kosela&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Korzeniewska-Kosela Maria</a>, <a href="/search?value1=Liga+Kuksa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kuksa Liga</a>, <a href="/search?value1=Heinke+Kunst&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kunst Heinke</a>, <a href="/search?value1=Christian+Lienhardt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lienhardt Christian</a>, <a href="/search?value1=Beatrice+Mahler&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mahler Beatrice</a>, <a href="/search?value1=Mateja+Jankovi%C4%87+Makek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Makek Mateja Janković</a>, <a href="/search?value1=Inge+Muylle&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Muylle Inge</a>, <a href="/search?value1=Johan+Normark&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Normark Johan</a>, <a href="/search?value1=Analita+Pace-Asciak&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pace-Asciak Analita</a>, <a href="/search?value1=Goranka+Petrovi%C4%87&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Petrović Goranka</a>, <a href="/search?value1=Despo+Pieridou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pieridou Despo</a>, <a href="/search?value1=Giulia+Russo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Russo Giulia</a>, <a href="/search?value1=Olena+Rzhepishevska&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rzhepishevska Olena</a>, <a href="/search?value1=Helmut+J.F.+Salzer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Salzer Helmut J.F.</a>, <a href="/search?value1=Marta+S%C3%A1+Marques&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marques Marta Sá</a>, <a href="/search?value1=Daniela+Schmid&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schmid Daniela</a>, <a href="/search?value1=Ivan+Solovic&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Solovic Ivan</a>, <a href="/search?value1=Mariya+Sukholytka&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sukholytka Mariya</a>, <a href="/search?value1=Petra+Svetina&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Svetina Petra</a>, <a href="/search?value1=Mariya+Tyufekchieva&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tyufekchieva Mariya</a>, <a href="/search?value1=Tuula+Vasankari&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vasankari Tuula</a>, <a href="/search?value1=Piret+Viiklepp&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Viiklepp Piret</a>, <a href="/search?value1=Kersti+Villand&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Villand Kersti</a>, <a href="/search?value1=Jiri+Wallenfels&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wallenfels Jiri</a>, <a href="/search?value1=Stefan+Wesolowski&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wesolowski Stefan</a>, <a href="/search?value1=Anna-Maria+Mandalakas&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mandalakas Anna-Maria</a>, <a href="/search?value1=Leonardo+Martinez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Martinez Leonardo</a>, <a href="/search?value1=Dominik+Zenner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zenner Dominik</a>, <a href="/search?value1=Christoph+Lange&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lange Christoph</a>, <a href="/search?value1=on+behalf+of+the+TBnet&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the TBnet</a>. Tuberculosis incidence in foreign-born people residing in European countries in 2020. <a href="/content/ecdc">Euro Surveill.</a> 2023;28(42):pii=2300051. <a href="https://doi.org/10.2807/1560-7917.ES.2023.28.42.2300051" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2023.28.42.2300051</a> Received: 24 Jan 2023;   Accepted: 12 May 2023

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Tuberculosis incidence in foreign-born people residing in European countries in 2020

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