Tuberculosis in native- and foreign-born populations in Portugal

Abstract

BACKGROUND: Tuberculosis (TB) is a major global health problem, and during the last 20 years, industrialised countries have shown similar patterns in TB notifications: decreasing TB incidence in native populations and increasing incidence in foreign-born populations. OBJECTIVES: To characterise risk factors associated with TB among native- and foreign-born TB patients in Portugal and identify barriers to the management of foreign cases. METHODS: Analysis of the data from the national tuberculosis surveillance system and data from an online survey of physicians managing TB cases in the country. RESULTS: Risk factors in the two populations differed. Foreign-born patients were younger, less likely to use drugs or alcohol and had fewer comorbidities. They were also more likely to be human immunodeficiency virus positive, to be employed and to be homeless/living in shelters. The outcome of the disease and the time to diagnosis were not significantly different between the two populations. The most important barriers to the management of foreign-born TB cases were language and fear of deportation. CONCLUSIONS: As there are significant differences between the two populations, different TB control strategies should be implemented in the two populations.