Oral presentations: abstracts

2012 European Journal of Public Health  
Due to its geographical position in the middle of the Mediterranean and at the threshold of Europe, Malta has been experiencing a large influx of irregular migration since 2002 . Between 2002 and 2010 immigrants are known to have landed in Malta by boat, many originating from Africa. Like other Western European countries, tuberculosis (TB) notification and incidence rates decreased steadily among Maltese nationals in recent decades. Nowadays, a substantial proportion of TB cases detected are
more » ... ng migrants from high-prevalence countries. Between 2003 and 2007, while the overall notification rates in Western Europe decreased in most countries, substantial increases were observed in Malta (+61.4% mean annual percent change in rate, [2003][2004][2005][2006][2007]. For effective TB control in Malta it is important to examine the effect of immigration on its TB epidemiology. This study sets out to describe the TB trends in Malta and the characteristics of TB in these migrants and compare them with Maltese TB cases to tailor TB control strategies accordingly. Methods Retrospective population study of national TB surveillance data from 1995-2010. Results Between 1995-2010, the overall TB rate in Malta increased from 2.6/100,000 to 7.7/100,000 (P = 0.05) while the Maltese rate decreased (P < 0.001). The migrant TB rate was 347/ 100,000 compared to 2.7/100,000 Maltese rate. Sixty-nine percent of migrant cases were detected during the first 12 months of entry in Malta. The proportion of migrant TB cases increased from 33% in 2002 to 72% in 2010 (P = 0.004). All migrant TB cases in 2010 entered Malta in the preceding years. Conclusion During 1995-2010, the overall TB rate in Malta increased. This rise may be mainly due to the recent large influx of migrants from high-prevalence countries and to the increasing proportions of migrant TB cases as the Maltese rate has decreased. Awareness of increased risk of TB disease in migrants needs to be an ongoing process not just at entry but for many years after arrival, even in resettlement countries. This is of importance as Malta often serves as a transit country into Europe. Following this study, screening protocols in new entrants from highincidence countries have been revised and a national TB control strategy launched. Effect of adopting host-country nationality (naturalisation) on perinatal mortality rates and causes among immigrants in Brussels
doi:10.1093/eurpub/cks114 fatcat:uozij66ianhupnzlnvz53ed5aq