[Comparative epidemiological study of the tuberculosis - migrant and native subjects in Guadeloupe from 2006 to 2011].
Résumé
INTRODUCTION: Most of the migrants residing in Guadeloupe are from neighboring Caribbean islands, some of which are characterized by a high incidence of tuberculosis. The objective of this retrospective and observational study was to define the epidemiological characteristics of tuberculosis affecting migrant and native populations in Guadeloupe. METHODS: We describe all cases of tuberculosis in Guadeloupe identified in these two populations between 1 July 2006 and 30 June 2011. RESULTS: The incidence of TB among migrants in Guadeloupe was seven times higher than that in native subjects in 2010 (33.4 vs. 5.5 new cases/100,000 inhabitants). Tuberculosis affecting the migrant population was characterized by young age of the patients (42 vs. 55 years) and a significant proportion of co-infection by the human immunodeficiency virus (HIV) (47 vs. 14%, P<0.001). Among the patient population studied, the HIV infection increased the risk of developing severe tuberculosis (adjusted odds ratio: 2.9; 95%CI: 1.2-6.8). Moreover, HIV infection was also a risk factor for death where the infection was not controlled (CD4 count <200 units per microliter; adj risk ratio: 3.9; 1.2-12.4). CONCLUSION: This study shows that the migrant population in Guadeloupe is at increased risk of tuberculosis and should be considered as a priority target for tuberculosis control program.