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BMC Medicine
Published in: BMC Medicine 1/2018

Open Access 01-12-2018 | Research article

Migration and tuberculosis transmission in a middle-income country: a cross-sectional study in a central area of São Paulo, Brazil

Authors: Julia Moreira Pescarini, Vera Simonsen, Lucilaine Ferrazoli, Laura C. Rodrigues, Rosangela S. Oliveira, Eliseu Alves Waldman, Rein Houben

Published in: BMC Medicine | Issue 1/2018

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Abstract

Background

Little is known about the impact of growing migration on the pattern of tuberculosis (TB) transmission in middle-income countries. We estimated TB recent transmission and its associated factors and investigated the presence of cross-transmission between South American migrants and Brazilians.

Methods

We studied a convenient sample of cases of people with pulmonary TB in a central area of São Paulo, Brazil, diagnosed between 2013 and 2014. Cases with similar restriction fragment length polymorphism (IS6110-RFLP) patterns of their Mycobacterium tuberculosis complex isolates were grouped in clusters (recent transmission). Clusters with both Brazilian and South American migrants were considered mixed (cross-transmission). Risk factors for recent transmission were studied using logistic regression.

Results

Isolates from 347 cases were included, 76.7% from Brazilians and 23.3% from South American migrants. Fifty clusters were identified, which included 43% South American migrants and 60.2% Brazilians (odds ratio = 0.50, 95% confidence interval = 0.30–0.83). Twelve cross-transmission clusters were identified, involving 24.6% of all clustered cases and 13.8% of all genotyped cases, with migrants accounting for either an equal part or fewer cases in 11/12 mixed clusters.

Conclusions

Our results suggest that TB disease following recent transmission is more common among Brazilians, especially among those belonging to high-risk groups, such as drug users. Cross-transmission between migrants and Brazilians was present, but we found limited contributions from migrants to Brazilians in central areas of São Paulo and vice versa.
Appendix
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Footnotes
1
The population considered near poor in a monetary sense has an equivalent income of more than $1.25 a day but less than $2.50 a day [23].
 
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Metadata
Title
Migration and tuberculosis transmission in a middle-income country: a cross-sectional study in a central area of São Paulo, Brazil
Authors
Julia Moreira Pescarini
Vera Simonsen
Lucilaine Ferrazoli
Laura C. Rodrigues
Rosangela S. Oliveira
Eliseu Alves Waldman
Rein Houben
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2018
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-018-1055-1

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