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Free Content Risk of travelling to the country of origin for tuberculosis among immigrants living in a low-incidence country

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SETTING: Two thirds of tuberculosis (TB) patients in the Netherlands are foreign-born.

OBJECTIVE: To determine if travelling to the country of origin is a risk factor for TB among two different immigrant groups that have lived in the Netherlands for at least 2 years.

DESIGN: In this unmatched case-control study, the frequency and duration of travel to the country of origin in the preceding 12 months were compared between adult Moroccan and Turkish TB patients and community controls.

RESULTS: Moroccan patients had travelled more often (26/32 = 81%) in the preceding year than Moroccan controls (472/816 = 58%). The travel-associated odds ratio (OR) for TB among Moroccans was 3.2 (95%CI 1.3–7.7), and increased to 17.2 (95%CI 3.7–79) when the cumulative duration of travel exceeded 3 months. The corresponding population fraction of Moroccan TB cases attributable to recent travel was 56% (95%CI 19–71). Among Turkish immigrants TB was not associated with travel (OR 0.9, 95%CI 0.3–2.4).

CONCLUSION: Travel to the country of origin was a risk factor for TB among Moroccans, but not among Turkish people living in the Netherlands. The difference in travel-associated OR between these two immigrant groups is probably related to differences in TB incidence in these countries.
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Keywords: attributable risk; case-control study; immigrants; travel; tuberculosis

Document Type: Regular Paper

Affiliations: 1: KNCV Tuberculosis Foundation, The Hague, The Netherlands; University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands 2: Department of Tuberculosis Control, Municipal Health Service, Amsterdam, The Netherlands 3: KNCV Tuberculosis Foundation, The Hague, The Netherlands 4: The Netherlands Institute for Social Research (SCP), The Hague, The Netherlands 5: Department of Epidemiology and Information, Municipal Health Service, Utrecht, The Netherlands

Publication date: January 1, 2011

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  • 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

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