title: Adult tuberculosis in Israel and migration: trends and challenges between 1999 and 2010.
abstract: BACKGROUND
  Israel absorbs many migrants from countries with a high prevalence of tuberculosis (TB).
  
  
  OBJECTIVE
  To describe the epidemiology of TB among adults in Israel between 1999 and 2010 and identify populations with a high TB burden.
  
  
  METHODS
  Data were retrieved from the National Tuberculosis Registry and the Israeli Bureau of Statistics.
  
  
  RESULTS
  A total of 4652 adult TB patients were notified during the study period, with rates decreasing annually from 7.5 per 100,000 population in 1999 to 4.3 in 2010. Most (n = 3745, 80.5%) had pulmonary TB, the average female:male ratio was 1:1.4, and 227 (5.1%) were infected with the human immunodeficiency virus. Of all TB patients, 4079 (87.6%) were born outside Israel; of these, 3338 were citizens and 741 non-citizen migrant workers (MWs). The average annual rates of TB among Israeli-born citizens, foreign-born citizens and MWs were respectively 0.86, 11.9 and 27/100,000. The ratio of MWs to foreign-born citizens fell from 1:11.7 in 1999 to 1:1.5 in 2010. TB was diagnosed 13.9 ± 7.5 years following entry to Israel, mostly during the first year. Of 3551 isolates, 222 (4.5%) were multidrug-resistant; most (95.6%) were from foreign-born patients. The average treatment success rate for smear-positive pulmonary TB was 84.3%.
  
  
  CONCLUSIONS
  TB rates have decreased, while the proportion of foreign-born subjects, particularly MWs, has increased. Adherence to preventive treatment can prevent TB in these cases.
authors.affiliation: Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel. zohar.mor@rml.health.gov.il
authors.forename: Z
authors.initials: Z
authors.lastname: Mor
authors.forename: G
authors.initials: G
authors.lastname: Pinsker
authors.forename: N
authors.initials: N
authors.lastname: Cedar
authors.forename: M
authors.initials: M
authors.lastname: Lidji
authors.forename: I
authors.initials: I
authors.lastname: Grotto
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D060085:Coinfection / Q000453:epidemiology; D018563:Disease Notification; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration / Q000639:trends*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D012111:Residence Characteristics; D013997:Time Factors; D014171:Transients and Migrants; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents