Tuberculosis in Immigrants to Cartagena de Indias, Colombia

Abstract

Introduction: Tuberculosis (TB) affects vulnerable populations. Immigrants have contributed to the increased incidence of TB. In this population, TB has some common characteristics that can lead to increased resistance to anti-TB drugs and undesired outcomes. In Cartagena de Indias, Colombia, an increase in TB cases has been observed in immigrants. Our objective is to describe the clinical and microbiological characteristics of Mycobacterium tuberculosis in the immigrant population of Cartagena de Indias, Colombia. Methods: A descriptive study of 101 patients with a clinical and microbiological diagnosis of TB was carried out in the city of Cartagena de Indias, Colombia from December 2017 to December 2018. The clinical spectrum and sensitivity profile of M. tuberculosis to first-line anti-TB drugs were characterized by phenotypic tests and molecular markers of resistance. Confidence intervals were calculated for the estimates. Statistical significance was considered at P≤0.05. Results: A total of 101 patients were analyzed. 8.91% (95% CI: 4.16-16.24%) of the study population were immigrants. Extrapulmonary tuberculosis (EPTB) occurred more frequently among immigrants than in the native population (44.44%; 95% CI 13.70-78.80% vs. 4.49%; 95% CI 1.24-11.11%; P = 0.002). The immigrants also had a higher frequency of cases with resistance (15.22 vs. 44.44%; P = 0.051) and undesired outcomes, such as therapeutic failure (8.70% vs. 33.33%; P = 0.001) and death (4.35% vs. 44.44%; P = 0.001). Conclusion: Immigrant TB patients were more likely to present particular clinical characteristics, such as HIV coinfection, malnutrition, constitutional manifestations, extrapulmonary spread, the presence of caverns, and undesired outcomes.