MDR-TB is a threat to global TB control. Identification of risk groups is crucial in low prevalence countries for early diagnosis and to limit transmission. Retrospective evaluation of TB cases treated at the Villa Marelli Inst., Milan, Italy, in the years 2000-2010. Susceptible TB patients (sTB) and MDR-TB patients were considered for the analysis. Potential risk factors for MDR, such as age, thoracic or extra-toracic involvement, HIV status, country of origin, etc were evaluated in a logistic regression model. Results: 91 MDR-TB and 1510 sTB patients were recorded in the study period. HIV seropositive status (OR 3.98, CI95% 1.52 -10.39) and being migrant (IM) from Eastern European countries (OR 3.35, CI95% 1.48 -7.56) were independently associated to MDR-TB. Stratifying for sex, female subjects from Eastern Europe, South America and Asia had an higher risk than male from the same regions (East-European women OR 10.37 CI95% 1.84-58.26 vs men OR 2.06 CI 95% 0.77-5.50; South American women OR 7.06 CI 95% 1.35-36.90 vs men OR 1.04 CI 95% 0.35-3.04; Asian women OR 7.69 CI 95% 1.19-49.68 vs men OR 1.39 CI 95% 0.47-4.11).Treatment success were more frequent in IM women than men both in sTB (94% vs 88%, P 0.01) and MDR-TB (90%vs 67%, P0.02), in sTB Italian than IM men (94%vs 88%, P0.01) and in MDR IM than Italian men (67%vs 36%, P0.02). Conclusions: In an European metropolitan setting, MDR-TB is associated with origin from regions with high prevalence and with HIV seropositive status. The finding that female subjects from Eastern Europe, South America and Asia are at increased risk, opens important questions about equal access to health care and the need of targeted studies.
Gender and other risk factors for multidrug-resistant (MDR) tuberculosis (TB) among migrants to Milan, Italy
N. Murgia;
2011
Abstract
MDR-TB is a threat to global TB control. Identification of risk groups is crucial in low prevalence countries for early diagnosis and to limit transmission. Retrospective evaluation of TB cases treated at the Villa Marelli Inst., Milan, Italy, in the years 2000-2010. Susceptible TB patients (sTB) and MDR-TB patients were considered for the analysis. Potential risk factors for MDR, such as age, thoracic or extra-toracic involvement, HIV status, country of origin, etc were evaluated in a logistic regression model. Results: 91 MDR-TB and 1510 sTB patients were recorded in the study period. HIV seropositive status (OR 3.98, CI95% 1.52 -10.39) and being migrant (IM) from Eastern European countries (OR 3.35, CI95% 1.48 -7.56) were independently associated to MDR-TB. Stratifying for sex, female subjects from Eastern Europe, South America and Asia had an higher risk than male from the same regions (East-European women OR 10.37 CI95% 1.84-58.26 vs men OR 2.06 CI 95% 0.77-5.50; South American women OR 7.06 CI 95% 1.35-36.90 vs men OR 1.04 CI 95% 0.35-3.04; Asian women OR 7.69 CI 95% 1.19-49.68 vs men OR 1.39 CI 95% 0.47-4.11).Treatment success were more frequent in IM women than men both in sTB (94% vs 88%, P 0.01) and MDR-TB (90%vs 67%, P0.02), in sTB Italian than IM men (94%vs 88%, P0.01) and in MDR IM than Italian men (67%vs 36%, P0.02). Conclusions: In an European metropolitan setting, MDR-TB is associated with origin from regions with high prevalence and with HIV seropositive status. The finding that female subjects from Eastern Europe, South America and Asia are at increased risk, opens important questions about equal access to health care and the need of targeted studies.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
