Impact of immigration and HIV infection on tuberculosis incidence in an area of low tuberculosis prevalence

2006 
SUMMARY The aim of this study is to assess the effects of immigration from countries with a high prevalence of tuberculosis (HPCs), of HIV/AIDS prevalence, and the ageing of the indigenous population, on tuberculosis distribution in a low-prevalence area (LPCs), the Piedmont Region of Italy. Tuberculosis incidence and HIV cases were identified by linking records from the surveillance systems. Overall, 640 tuberculosis cases were identified and crude annual incidence was found to be 17 . 3/100 000. The incidence rate ratio for HIV infection as a risk factor for tuberculosis (11 . 4 and 51 . 9 among individuals from HPCs and LPCs respectively) was greater than that for immigration from HPCs (6 . 7a nd 30 . 9 among HIV+ and HIVx individuals). Immigration accounted for a larger number of incident cases [population attributable risk % (PAR %) : 31 . 8 and 52 . 8 % among HIV+ and HIVx individuals] than did HIV infection (PAR % : 5 . 4 and 11 . 1% among individuals from HPCs and LPCs). Efforts should be made to identify and treat
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