title: Tuberculosis in immigrants in Finland, 1995-2013.
abstract: Increasing immigration from high tuberculosis (TB) incidence countries is a challenge for surveillance and control in Finland. Here, we describe the epidemiology of TB in immigrants by using national surveillance data. During 1995-2013, 7030 (84·7%) native and 1199 (14·4%) immigrant cases were identified. The proportion of immigrant cases increased from 5·8% in 1995 to 32·1% in 2013, consistent with increasing immigrant population (2·1-5·6%) and decreasing incidence of TB in the native population (from 12·1 to 3·5/100 000). TB cases in immigrants were significantly younger, more often female, and had extrapulmonary TB more often than native cases (P < 0·01 for all comparisons); multidrug resistance was also more common in immigrants than natives (P < 0·01). Immigrant cases were born in 82 different countries; most commonly in Somalia and the former Soviet Union/Russia. During 2008-2013, 433 Mycobacterium tuberculosis isolates from immigrants were submitted for spoligotyping; 10 different clades were identified. Clades were similar to those found in the case's country of birth. Screening immigrants from high-incidence countries and raising awareness of common characteristics and symptoms of TB is important to ensure early diagnosis and to prevent transmission.
authors.affiliation: Department of Infectious Diseases,National Institute for Health and Welfare (THL),Helsinki,Finland.
authors.forename: P E
authors.initials: PE
authors.lastname: Räisänen
authors.affiliation: Department of Infectious Diseases,National Institute for Health and Welfare (THL),Helsinki,Finland.
authors.forename: H
authors.initials: H
authors.lastname: Soini
authors.affiliation: Finnish Lung Health Association (Filha),Helsinki,Finland.
authors.forename: T
authors.initials: T
authors.lastname: Vasankari
authors.affiliation: Department of Infectious Diseases,National Institute for Health and Welfare (THL),Helsinki,Finland.
authors.forename: P W
authors.initials: PW
authors.lastname: Smit
authors.affiliation: Department of Infectious Diseases,National Institute for Health and Welfare (THL),Helsinki,Finland.
authors.forename: J P
authors.initials: JP
authors.lastname: Nuorti
authors.affiliation: Department of Infectious Diseases,National Institute for Health and Welfare (THL),Helsinki,Finland.
authors.forename: J
authors.initials: J
authors.lastname: Ollgren
authors.affiliation: Department of Infectious Diseases,National Institute for Health and Welfare (THL),Helsinki,Finland.
authors.forename: P
authors.initials: P
authors.lastname: Ruutu
authors.affiliation: Department of Infectious Diseases,National Institute for Health and Welfare (THL),Helsinki,Finland.
authors.forename: O
authors.initials: O
authors.lastname: Lyytikäinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics*; D013997:Time Factors; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
keywords: Epidemiology; Mycobacterium tuberculosis; immigrants; molecular epidemiology; spoligotyping; tuberculosis (TB)