Differences in tuberculosis disease among immigrant and native populations

Introduction: Tuberculosis (TB) is a public health problem although its incidence has declined. In the last decade there has been an epidemiological shift caused by immigrants from high-prevalence countries, HIV infection and immunosuppressive treatments. Barcelona reaches a TB incidence of > 90 per 100,000 inhabitants in some areas. Methodology: TB disease cases between 2006 and 2012 were retrospectively selected. Data on demographic and clinical characteristics, comorbidities, drug abuse, laboratory tests, radiographic pattern, treatment and resistances were collected. Results: 222 TB cases were included. 62.6% of the patients were immigrants, and the clinical presentation was pulmonary TB in 76.8%, pleural TB in 23.2% and nodal TB in 7.3% of the cases. These percentages were 86.7%, 19.3% and 2.4%, respectively in native population. No statistical differences were found in clinical presentation, radiographic pattern, treatment resistance or days of stay in hospital. Conclusions: TB disease in immigrants appears at a lower age than in native patients and in those patients living in group. There are no differences in clinical, radiological presentations and in the development of resistances to treatment. Since immigrant patients showed more smear negativity, this might suggest indication for >3 serial sputum analysis and sustained isolation.