title: The impact of immigration on the elimination of tuberculosis in The Netherlands: a model based approach.
abstract: OBJECTIVE
  To determine whether elimination of tuberculosis in the Dutch population can be achieved by the year 2030, taking into account the impact of immigration.
  
  
  METHODS
  The incidence of tuberculosis (all forms) in the period 1970 to 2030 was estimated using a life-table model for the Dutch population without the impact of immigration. The influence of immigration on tuberculosis incidence among the Dutch was modelled using four immigrant scenarios, distinguished by the assumed contact rate between immigrants and the Dutch population, and by different projections (middle, upper) of the future size of the immigrant population in The Netherlands.
  
  
  RESULTS
  The incidence of smear-positive tuberculosis among the Dutch is projected to be 1.4 per million in the scenario without the influence of immigrant cases, and ranging from 3.8 to 11.8 per million in the four immigrant scenarios. In all immigrant scenarios, the prevalence of tuberculosis infection will continue to decline and be less than 1% by the year 2030. At least 60% of Dutch tuberculosis cases in the year 2030 are expected to be the result of transmission from a foreign source case.
  
  
  CONCLUSIONS
  Using a prevalence of tuberculosis infection of less than 1% as the elimination criterion, tuberculosis will probably be eliminated from the indigenous Dutch population by 2030. However, the incidence of smear-positive tuberculosis is expected to remain higher than 1 per million, and the majority of new tuberculosis cases among the Dutch may be attributable to recent infection from a foreign source case.
authors.affiliation: Pallas, Health Research and Consultancy, Rotterdam, The Netherlands.
authors.forename: den Bosch J H
authors.initials: dB
authors.lastname: Wolleswinkel-van
authors.forename: N J D
authors.initials: NJ
authors.lastname: Nagelkerke
authors.forename: J F
authors.initials: JF
authors.lastname: Broekmans
authors.forename: M W
authors.initials: MW
authors.lastname: Borgdorff
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000517:prevention & control