Skip to main content

Free Content Factors associated with the high tuberculosis case rate in an urban area

Download Article:
 Download
(PDF 349.7353515625 kb)
 

Abstract:

SETTING: The Rotterdam region, the Netherlands, 1995–2006.

OBJECTIVE: To identify factors associated with the high tuberculosis (TB) case rate in an urban area.

DESIGN: Municipalities were divided into urban and semi-urban/rural municipalities. We compared the characteristics of TB cases and stratified case rates according to age group, immigrant status and place and time of infection between the two areas.

RESULTS: The TB case rate in urban municipalities was 3.8-fold higher than in semi-urban/rural municipalities. After stratification for country of birth, the rate ratios were lower (1.7 for immigrants and 2.8 for non-immigrants). Immigrants had most frequently acquired their infection abroad (47% of urban and 62% of semi-urban/rural immigrant cases). In 40% of urban cases and 27% of semi-urban/rural cases, the infection was recently acquired in the Netherlands, translating into a 5.7-fold higher recent transmission case rate for the urban population.

CONCLUSIONS: The high urban TB case rate was related to the high proportion of urban immigrants who frequently reactivated an infection acquired abroad. Recent transmission also contributed to a substantial part of the TB caseload in urban municipalities among both urban immigrants and non-immigrants. The authors propose a package of targeted interventions to address the identified factors associated with the high urban TB case rate.

Keywords: DNA fingerprinting; molecular epidemiology; tuberculosis; urban health

Document Type: Regular Paper

Affiliations: 1: Department of Tuberculosis Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands; Department of Public Health, Erasmus Medical Centre, University Medical Center Rotterdam, Rotterdam, The Netherlands 2: Department of Tuberculosis Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands 3: National Mycobacteria Reference Laboratory, National Institute of Public Health and the Environment, Bilthoven, The Netherlands; and KNCV Tuberculosis Foundation, The Hague, The Netherlands 4: Department of Public Health, Erasmus Medical Centre, University Medical Center Rotterdam, Rotterdam, The Netherlands; and Division of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands

Publication date: 2010-07-01

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • International Journal of Tuberculosis and Lung Disease
  • Public Health Action
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more