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Multidrug-resistant tuberculosis imported into low-incidence countries-a GeoSentinel analysis, 2008-2020

dc.rights.licenseopenen_US
dc.contributor.authorEIMER, Johannes
dc.contributor.authorPATIMETEEPORN, Calvin
dc.contributor.authorJENSENIUS, Mogens
dc.contributor.authorGKRANIA-KLOTSAS, Effrossyni
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorDUVIGNAUD, Alexandre
dc.contributor.authorBARNETT, Elizabeth D.
dc.contributor.authorHOCHBERG, Natasha S.
dc.contributor.authorCHEN, Lin H.
dc.contributor.authorTRIGO-ESTEBAN, Elena
dc.contributor.authorGERTLER, Maximilian
dc.contributor.authorGREENAWAY, Christina
dc.contributor.authorGROBUSCH, Martin P.
dc.contributor.authorANGELO, Kristina M.
dc.contributor.authorHAMER, Davidson H.
dc.contributor.authorCAUMES, Eric
dc.contributor.authorASGEIRSSON, Hilmir
dc.date.accessioned2021-07-05T10:28:03Z
dc.date.available2021-07-05T10:28:03Z
dc.date.issued2021-05-12
dc.identifier.issn1195-1982en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/94979
dc.description.abstractEnBACKGROUND: Early detection of imported multidrug-resistant tuberculosis (MDR-TB) is crucial, but knowledge gaps remain about migration- and travel-associated MDR-TB epidemiology. The aim was to describe epidemiologic characteristics among international travelers and migrants with MDR-TB. METHODS: Clinician-determined and microbiologically confirmed MDR-TB diagnoses deemed to be related to travel or migration were extracted from GeoSentinel, a global surveillance network of travel and tropical medicine clinics, from January 2008 through December 2020. MDR-TB was defined as resistance to both isoniazid and rifampicin. Additional resistance to either a fluoroquinolone or a second-line injectable drug was categorized as pre-extensively drug-resistant (pre-XDR) TB, and as extensively drug-resistant (XDR) TB when resistance was detected for both. Sub-analyses were performed based on degree of resistance and country of origin. RESULTS: Of 201 patients, 136 had MDR-TB (67.7%), 25 had XDR-TB (12.4%), 23 had pre-XDR TB (11.4%), and 17 had unspecified MDR- or XDR-TB (8.5%); 196 (97.5%) were immigrants, of which 92 (45.8%) originated from the former Soviet Union. The median interval from arrival to presentation was 154 days (interquartile range [IQR]: 10-751 days); 34.3% of patients presented within 1 month after immigration, 30.9% between 1 and 12 months, and 34.9% after ≥1 year. Pre-XDR- and XDR-TB patients from the former Soviet Union other than Georgia presented earlier than those with MDR-TB (26 days [IQR: 8-522] vs. 369 days [IQR: 84-827]) while patients from Georgia presented very early, irrespectively of the level of resistance (8 days [IQR: 2-18] vs. 2 days [IQR: 1-17]). CONCLUSIONS: MDR-TB is uncommon in traditional travellers. Purposeful medical migration may partly explain differences in time to presentation among different groups. Public health resources are needed to better understand factors contributing to cross-border MDR-TB spread and to develop strategies to optimize care of TB-infected patients in their home countries before migration.
dc.language.isoENen_US
dc.subject.enTravel
dc.subject.enepidemiology
dc.subject.enImmigration
dc.subject.enMigrant
dc.subject.enMedical migration
dc.subject.enExtensively drug-resistant tuberculosis
dc.subject.enMDR-TB
dc.title.enMultidrug-resistant tuberculosis imported into low-incidence countries-a GeoSentinel analysis, 2008-2020
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/jtm/taab069en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed33987682en_US
bordeaux.journalJournal of Travel Medicineen_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamIDLICen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03278070
hal.version1
hal.date.transferred2021-07-05T10:28:07Z
hal.exporttrue
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