[Prevalence of tuberculosis infection among immigrants in the Toledo Health District, Spain]. / Prevalencia de infección tuberculosa en las personas inmigrantes del Area de Salud de Toledo.

BACKGROUND: The rise in the frequency of tuberculosis is due to several factors: resistance to treatment, human immunodeficiency virus infection, unemployment, poverty and migratory movements. This study is aimed at ascertaining the prevalence of tuberculosis infection among the immigrant population in the Toledo Health District. METHODS: Descriptive, cross-sectional, multi-center study conducted at the Primary Care level. The immigrants were attracted and recruited on the based of their health cards within the December 2002-September 2003 period. Mantoux intradermal reaction test was performed with 0.1 ml (2UT) of PPD RT-23, following informed consent. Other variables were collected: age, sex, weight, country of origin, work situation, BCG vaccination, number of individuals living with them, length of time residing in Europe. RESULTS: A total of 344 immigrants were included in the study, averaging 28.8 +/- 12.7 years of age. Fifty percent were females (172). They had been living in Europe for an average of 3.4 +/- 3.7 years. A total 78.8% (271) of the immigrants completed the study. The intradermal reaction was positive in 75 of them [27.7% (CI 95%: 23-32.5)]. Those immigrants showing a positive Mantoux were older (age 32.5 +/- 8.5 years) than those showing a negative result (age 27.7 +/- 13.8 years), p=0.006. Originally being from the sub-Saharan area increased the probability of showing a positive intradermal reaction. CONCLUSIONS: The immigrant population of the Toledo Health District shows a high prevalence of tuberculosis infection, which is higher than the general Spanish population. Differences exist depending upon the country of origin. These results indicate the importance of considering the Mantoux test among the preventive activities addressed toward this immigrant population.

Prevalencia de infección tuberculosa en las personas inmigrantes del área de salud de Toledo / Prevalence of tuberculosis infection among immigrants in the Toledo Health District, Spain

Fundamento: El aumento en la frecuencia de tuberculosis (TB) se produce por varios factores: resistencias al tratamiento, la infección por el virus de la inmunodeficiencia humana, el paro, la pobreza y los movimientos migratorios. El objetivo del estudio fue conocer la prevalencia de infección tuberculosa en población inmigrante del Área de Salud de Toledo. Métodos: Estudio descriptivo, transversal y multicéntrico con emplazamiento en Atención Primaria. La captación y reclutamiento de las personas inmigrantes se realizó sobre base de tarjeta sanitaria, entre diciembre de 2002 y septiembre de 2003. Se realizó intradermorreacción de Mantoux (IDRM), con 0,1 ml (2UT) de PPD RT-23, previa firma del consentimiento informado. Otras variables recogidas fueron: edad, sexo, peso, país de origen, situación laboral, vacunación BCG, número de convivientes, tiempo de residencia en Europa. Resultados: Fueron incluidos 344 inmigrantes, con una edad media de 28,8±12,7 años. El 50% (172) eran mujeres. Llevaban un promedio de 3,4±3,7 años de residencia en Europa. El 78,8% (271) de las personas inmigrantes completaron el estudio. La IDRM fue positiva en 75 de ellos [27,7% (IC 95%: 23,1-32,5)]. Los inmigrantes con Mantoux positivo tenían más edad (32,5± 8,5 años) frente a (27,7 ± 13,8 años) en los que el resultado fue negativo, p=0,006. El origen subsahariano aumentaba la probabilidad de presentar IDRM positiva. Conclusiones: La población inmigrante del Área de Salud de Toledo presenta una prevalencia alta de infección tuberculosa, superior a la población general española. Existen diferencias según el país de origen. Estos resultados indican la importancia de considerar la prueba de Mantoux (AU)

Background: The rise in the frequency of tuberculosis is due to several factors: resistance to treatment, human immunodeficiency virus infection, unemployment, poverty and migratory movements. This study is aimed at ascertaining the prevalence of tuberculosis infection among the immigrant population in the Toledo Health District. Methods: Descriptive, cross-sectional, multicenter study conducted at the Primary Care level. The immigrants were attracted and recruited on the based of their health cards within the December 2002-September 2003 period. Mantoux intradermal reaction test was performed with 0.1 ml (2UT) of PPD RT-23, following informed consent. Other variables were collected: age, sex, weight, country of origin, work situation, BCG vaccination, number of individuals living with them, length of time residing in Europe. Results: A total of 344 immigrants were included in the study, averaging 28.8 ± 12.7 years of age. Fifty percent were females (172). They had been living in Europe for an average of 3.4±3.7 years. A total 78.8% (271) of the immigrants completed the study. The intradermal reaction was positive in 75 of them [27.7% (CI 95%: 23.- 32.5)]. Those immigrants showing a positive Mantoux were older (age 32.5 ± 8.5 years) than those showing a negative result (age 27.7 ± 13.8 years), p=0.006. Originally being from the sub-Saharan area increased the probability of showing a positive intradermal reaction. Conclusions: The immigrant population of the Toledo Health District shows a high prevalence of tuberculosis infection, which is higher than the general Spanish population. Differences exist depending upon the country of origin. These results indicate the importance of considering the Mantoux test among the preventive activities addressed toward this immigrant population (AU)