Tuberculosis among undocumented boat migrants to Malta: implications for a migrant tuberculosis policy
OBJECTIVES: To describe the demography and tuberculosis (TB) epidemiology of undocumented immigrants to Malta to tailor TB control strategies to this population.
DESIGN: Retrospective population study of undocumented immigrants to Malta using national TB surveillance data.
RESULTS: Overall, 85% (4570/5383) of undocumented immigrants were screened on entry using chest X-ray (CXR). Undocumented immigrants were mostly young adults aged 15–34 years (81%) and predominately male (86%), mostly originating from Africa (88%). On screening, 3.5% (160/4570) had CXR suggestive of TB, of whom 12.5% (20/160) had active TB. Using both active and passive surveillance, 33 cases of active TB were diagnosed in these immigrants, 94% of whom were diagnosed during their first 12 months of residence in Malta. Entry screening detected 61% (20/33) of cases (yield 0.44%). Of the total TB cases in Malta, the proportion of undocumented immigrants increased markedly from 33% in 2002 to 60% in 2005. The reported TB incidence among immigrants was 390/100 000 compared to 2.1/100 000 in the Malta-born.
CONCLUSION: Tailoring TB control strategies to this migrant population is essential for TB control in Malta. Awareness of increased risk of TB needs to be ongoing, not just at entry but for many years after arrival, even in resettlement countries.
Document Type: Research Article
Affiliations: 1: Infectious Disease Prevention and Control Unit, Superintendence of Public Health, Msida, Malta 2: Department of Public Health, University of Malta, Msida, Malta 3: Department of Health Information and Research, Guardamangia, Malta
Publication date: August 1, 2013
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.
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