Increasing foreign born tuberculosis cases in Turkey and their detailed analysis with 2016 data.

The number and incidence of registered tuberculosis (TB) patients has been declining steadily in Turkey, but foreign-born cases are increasing. With civil war in Syria, largest international migrating number of Syrians, more than 3 million people moved to Turkey brought TB cases. Aim of this study is to investigate the effect of increase in foreign and Syria born patients on TB control program of Turkey. We retrospectively evaluated records of the TB Department at the Ministry of Health. TB dispensaries have the records of all TB cases in their region and annually they report individualized data. We compared the disease characteristics of TB cases detected among foreign and native-born people in our country. Proportion of foreign-born TB cases among all TB patients was 0.7% in 2007 (n=139), it increased to 7.3% in 2016 (n=904); during these years Syrian immigrant TB patients increased from 0 to 508. Syrian patients accounted for 56.2% of foreign-born patients in 2016. Other countries with more TB patients in Turkey are; Afghanistan, Azerbaijan, Bulgaria, Turkmenistan, and Iraq. In 2016, the ratio of multi-drug resistant (MDR) TB was 3.0% in Turkey-born, 3.7% in Syrian-born and 10.4% in foreign-born except Syria patients. Treatment success in patients who started treatment in 2015 were 85.7%, 74.9%, and 77.3% in Turkey-, foreign- and Syria-born TB patients respectively. Syrian migrants are increasing ration of foreign-born patients among all TB patients in Turkey. Low treatment success in foreign-born cases, including Syrians, points to the need to improve TB treatment adherence in this group. High drug resistance rates among foreign born is another problem to be addressed