title: The effect of migration within the European Union/European Economic Area on the distribution of tuberculosis, 2007 to 2013.
abstract: Immigration from tuberculosis (TB) high-incidence countries is known to contribute notably to the TB burden in low-incidence countries. However, the effect of migration enabled by the free movement of persons within the European Union (EU)/European Economic Area (EEA) on TB notification has not been analysed. We analysed TB surveillance data from 29 EU/EEA countries submitted for the years 2007-2013 to The European Surveillance System. We used place of birth and nationality as proxy indicators for native, other EU/EEA and non-EU/EEA origin of the TB cases and analysed the characteristics of the subgroups by origin. From 2007-2013, a total of 527,467 TB cases were reported, of which 129,781 (24.6%) were of foreign origin including 12,566 (2.4%) originating from EU/EEA countries other than the reporting country. The countries reporting most TB cases originating from other EU/EEA countries were Germany and Italy, and the largest proportion of TB cases in individuals came from Poland (n=1,562) and Romania (n=6,285). At EU/EEA level only a small proportion of foreign TB cases originated from other EU/EEA countries, however, the uneven distribution of this presumed importation may pose a challenge to TB programmes in some countries.
authors.affiliation: European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
authors.forename: Vahur
authors.initials: V
authors.lastname: Hollo
authors.forename: Saara Magdalena
authors.initials: SM
authors.lastname: Kotila
authors.forename: Csaba
authors.initials: C
authors.lastname: Ködmön
authors.forename: Phillip
authors.initials: P
authors.lastname: Zucs
authors.forename: Marieke Johanna
authors.initials: MJ
authors.lastname: van der Werf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology; D018563:Disease Notification / Q000379:methods / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005062:European Union; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D011159:Population Surveillance; D014376:Tuberculosis / Q000453:epidemiology*; D055815:Young Adult
keywords: EU internal migration; EU/EEA Member States; foreign origin; surveillance; tuberculosis