Persistent risk of tuberculosis in migrants a decade after arrival in Australia.
OBJECTIVE
To examine the risk of tuberculosis (TB) in migrants a decade after their arrival in Australia.


METHODS
Retrospective review of laboratory-confirmed cases of TB in migrants diagnosed between 1990 and 2004 by the state TB reference laboratory in Victoria, analysed by a multivariate model comparing migrants diagnosed 10 or more years after arrival with those diagnosed within 10 years of arrival.


METHODS
Time to diagnosis; characteristics of migrants diagnosed with TB, including age, sex, region of birth, site of infection, and drug resistance.


RESULTS
A third of migrants (734/1924) were diagnosed with TB 10 or more years after arrival in Australia. This group was more likely to be European-born (adjusted odds ratio [AOR], 3.4; 95% CI, 2.4-5.0) and older than 34 years (35-49 years: AOR, 3.8; 95% CI, 2.0-7.0), reflecting the longer time European migrants have been in Australia. There were two distinct European groups: European Union (EU)/Western and Central/Eastern. The Central/Eastern group were from countries with current high TB rates and, compared with the EU/Western group, were younger (mean age, 50 v 64 years) and more likely to be diagnosed within 10 years of arrival (47% v 14%; P < 0.001).


CONCLUSIONS
European migrants were more likely to be diagnosed a decade or more after arrival in Australia. Once migrants from the currently high TB incidence areas of Asia and Africa have been in Australia for a similar period of time, their timing of diagnosis may resemble that for migrants from Europe. The current screening policy should be complemented with more sensitive techniques to detect latent TB.
McPherson
Michelle E
ME
Communicable Disease Control, Department of Human Services, Melbourne, VIC. michelle.mcpherson@health.sa.gov.au
Kelly
Heath
H
Patel
Mahomed S
MS
Leslie
David
D
D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D001208:Asia / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000208:ethnology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000208:ethnology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014171:Transients and Migrants; D014376:Tuberculosis / Q000175:diagnosis / Q000208:ethnology*; D014739:Victoria / Q000453:epidemiology