Tuberculosis in an Urban Area in China: Differences between Urban Migrants and Local Residents

Xin Shen, Zhen Xia, Xiangqun Li, Jie Wu, Lili Wang, Jing Li, Yuan Jiang, Juntao Guo, Jing Chen, Jianjun Hong, Zheng'an Yuan, Qichao Pan, Kathryn DeRiemer, Guomei Sun, Qian Gao, Jian Mei

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: The increase in urban migrants is one of major challenges for tuberculosis control in China. The different characteristics of tuberculosis cases between urban migrants and local residents in China have not been investigated before. Methodology/Principal Findings: We performed a retrospective study of all pulmonary tuberculosis patients reported in Songjiang district, Shanghai, to determine the demographic, clinical and microbiological characteristics of tuberculosis cases between urban migrants and local residents. We calculated the odds ratios (OR) and performed multivariate logistic regression to identify the characteristics that were independently associated with tuberculosis among urban migrants. A total of 1,348 pulmonary tuberculosis cases were reported during 2006-2008, among whom 440 (32.6%) were local residents and 908 (67.4%) were urban migrants. Urban migrant (38.9/100,000 population) had higher tuberculosis rates than local residents (27.8/100,000 population), and the rates among persons younger than age 35 years were 3 times higher among urban migrants than among local residents. Younger age (adjusted OR per additional year at risk = 0.92, 95% CI: 0.91-0.94, p<0.001), poor treatment outcome (adjusted OR = 4.12, 95% CI: 2.65-5.72, p<0.001), and lower frequency of any comorbidity at diagnosis (adjusted OR = 0.20, 95% CI: 0.13-0.26, p = 0.013) were significantly associated with tuberculosis patients among urban migrants. There were poor treatment outcomes among urban migrants, mainly from transfers to another jurisdiction (19.3% of all tuberculosis patients among urban migrants). Conclusions/Significance: A considerable proportion of tuberculosis cases in Songjiang district, China, during 2006-2008 occurred among urban migrants. Our findings highlight the need to develop and implement specific tuberculosis control strategies for urban migrants, such as more exhaustive case finding, improved case management and follow-up, and use of directly observed therapy (DOT).

Original languageEnglish (US)
Article numbere51133
JournalPLoS One
Volume7
Issue number11
DOIs
StatePublished - Nov 30 2012

Fingerprint

tuberculosis
urban areas
China
Tuberculosis
Logistics
odds ratio
Odds Ratio
Pulmonary Tuberculosis
lungs
Directly Observed Therapy
Case Management
retrospective studies
Population
Comorbidity
demographic statistics
Retrospective Studies
Logistic Models
Demography
therapeutics

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Tuberculosis in an Urban Area in China : Differences between Urban Migrants and Local Residents. / Shen, Xin; Xia, Zhen; Li, Xiangqun; Wu, Jie; Wang, Lili; Li, Jing; Jiang, Yuan; Guo, Juntao; Chen, Jing; Hong, Jianjun; Yuan, Zheng'an; Pan, Qichao; DeRiemer, Kathryn; Sun, Guomei; Gao, Qian; Mei, Jian.

In: PLoS One, Vol. 7, No. 11, e51133, 30.11.2012.

Research output: Contribution to journalArticle

Shen, X, Xia, Z, Li, X, Wu, J, Wang, L, Li, J, Jiang, Y, Guo, J, Chen, J, Hong, J, Yuan, Z, Pan, Q, DeRiemer, K, Sun, G, Gao, Q & Mei, J 2012, 'Tuberculosis in an Urban Area in China: Differences between Urban Migrants and Local Residents', PLoS One, vol. 7, no. 11, e51133. https://doi.org/10.1371/journal.pone.0051133
Shen, Xin ; Xia, Zhen ; Li, Xiangqun ; Wu, Jie ; Wang, Lili ; Li, Jing ; Jiang, Yuan ; Guo, Juntao ; Chen, Jing ; Hong, Jianjun ; Yuan, Zheng'an ; Pan, Qichao ; DeRiemer, Kathryn ; Sun, Guomei ; Gao, Qian ; Mei, Jian. / Tuberculosis in an Urban Area in China : Differences between Urban Migrants and Local Residents. In: PLoS One. 2012 ; Vol. 7, No. 11.
@article{ae6bf93451984ce2957549edaf173c8e,
title = "Tuberculosis in an Urban Area in China: Differences between Urban Migrants and Local Residents",
abstract = "Background: The increase in urban migrants is one of major challenges for tuberculosis control in China. The different characteristics of tuberculosis cases between urban migrants and local residents in China have not been investigated before. Methodology/Principal Findings: We performed a retrospective study of all pulmonary tuberculosis patients reported in Songjiang district, Shanghai, to determine the demographic, clinical and microbiological characteristics of tuberculosis cases between urban migrants and local residents. We calculated the odds ratios (OR) and performed multivariate logistic regression to identify the characteristics that were independently associated with tuberculosis among urban migrants. A total of 1,348 pulmonary tuberculosis cases were reported during 2006-2008, among whom 440 (32.6{\%}) were local residents and 908 (67.4{\%}) were urban migrants. Urban migrant (38.9/100,000 population) had higher tuberculosis rates than local residents (27.8/100,000 population), and the rates among persons younger than age 35 years were 3 times higher among urban migrants than among local residents. Younger age (adjusted OR per additional year at risk = 0.92, 95{\%} CI: 0.91-0.94, p<0.001), poor treatment outcome (adjusted OR = 4.12, 95{\%} CI: 2.65-5.72, p<0.001), and lower frequency of any comorbidity at diagnosis (adjusted OR = 0.20, 95{\%} CI: 0.13-0.26, p = 0.013) were significantly associated with tuberculosis patients among urban migrants. There were poor treatment outcomes among urban migrants, mainly from transfers to another jurisdiction (19.3{\%} of all tuberculosis patients among urban migrants). Conclusions/Significance: A considerable proportion of tuberculosis cases in Songjiang district, China, during 2006-2008 occurred among urban migrants. Our findings highlight the need to develop and implement specific tuberculosis control strategies for urban migrants, such as more exhaustive case finding, improved case management and follow-up, and use of directly observed therapy (DOT).",
author = "Xin Shen and Zhen Xia and Xiangqun Li and Jie Wu and Lili Wang and Jing Li and Yuan Jiang and Juntao Guo and Jing Chen and Jianjun Hong and Zheng'an Yuan and Qichao Pan and Kathryn DeRiemer and Guomei Sun and Qian Gao and Jian Mei",
year = "2012",
month = "11",
day = "30",
doi = "10.1371/journal.pone.0051133",
language = "English (US)",
volume = "7",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "11",

}

TY - JOUR

T1 - Tuberculosis in an Urban Area in China

T2 - Differences between Urban Migrants and Local Residents

AU - Shen, Xin

AU - Xia, Zhen

AU - Li, Xiangqun

AU - Wu, Jie

AU - Wang, Lili

AU - Li, Jing

AU - Jiang, Yuan

AU - Guo, Juntao

AU - Chen, Jing

AU - Hong, Jianjun

AU - Yuan, Zheng'an

AU - Pan, Qichao

AU - DeRiemer, Kathryn

AU - Sun, Guomei

AU - Gao, Qian

AU - Mei, Jian

PY - 2012/11/30

Y1 - 2012/11/30

N2 - Background: The increase in urban migrants is one of major challenges for tuberculosis control in China. The different characteristics of tuberculosis cases between urban migrants and local residents in China have not been investigated before. Methodology/Principal Findings: We performed a retrospective study of all pulmonary tuberculosis patients reported in Songjiang district, Shanghai, to determine the demographic, clinical and microbiological characteristics of tuberculosis cases between urban migrants and local residents. We calculated the odds ratios (OR) and performed multivariate logistic regression to identify the characteristics that were independently associated with tuberculosis among urban migrants. A total of 1,348 pulmonary tuberculosis cases were reported during 2006-2008, among whom 440 (32.6%) were local residents and 908 (67.4%) were urban migrants. Urban migrant (38.9/100,000 population) had higher tuberculosis rates than local residents (27.8/100,000 population), and the rates among persons younger than age 35 years were 3 times higher among urban migrants than among local residents. Younger age (adjusted OR per additional year at risk = 0.92, 95% CI: 0.91-0.94, p<0.001), poor treatment outcome (adjusted OR = 4.12, 95% CI: 2.65-5.72, p<0.001), and lower frequency of any comorbidity at diagnosis (adjusted OR = 0.20, 95% CI: 0.13-0.26, p = 0.013) were significantly associated with tuberculosis patients among urban migrants. There were poor treatment outcomes among urban migrants, mainly from transfers to another jurisdiction (19.3% of all tuberculosis patients among urban migrants). Conclusions/Significance: A considerable proportion of tuberculosis cases in Songjiang district, China, during 2006-2008 occurred among urban migrants. Our findings highlight the need to develop and implement specific tuberculosis control strategies for urban migrants, such as more exhaustive case finding, improved case management and follow-up, and use of directly observed therapy (DOT).

AB - Background: The increase in urban migrants is one of major challenges for tuberculosis control in China. The different characteristics of tuberculosis cases between urban migrants and local residents in China have not been investigated before. Methodology/Principal Findings: We performed a retrospective study of all pulmonary tuberculosis patients reported in Songjiang district, Shanghai, to determine the demographic, clinical and microbiological characteristics of tuberculosis cases between urban migrants and local residents. We calculated the odds ratios (OR) and performed multivariate logistic regression to identify the characteristics that were independently associated with tuberculosis among urban migrants. A total of 1,348 pulmonary tuberculosis cases were reported during 2006-2008, among whom 440 (32.6%) were local residents and 908 (67.4%) were urban migrants. Urban migrant (38.9/100,000 population) had higher tuberculosis rates than local residents (27.8/100,000 population), and the rates among persons younger than age 35 years were 3 times higher among urban migrants than among local residents. Younger age (adjusted OR per additional year at risk = 0.92, 95% CI: 0.91-0.94, p<0.001), poor treatment outcome (adjusted OR = 4.12, 95% CI: 2.65-5.72, p<0.001), and lower frequency of any comorbidity at diagnosis (adjusted OR = 0.20, 95% CI: 0.13-0.26, p = 0.013) were significantly associated with tuberculosis patients among urban migrants. There were poor treatment outcomes among urban migrants, mainly from transfers to another jurisdiction (19.3% of all tuberculosis patients among urban migrants). Conclusions/Significance: A considerable proportion of tuberculosis cases in Songjiang district, China, during 2006-2008 occurred among urban migrants. Our findings highlight the need to develop and implement specific tuberculosis control strategies for urban migrants, such as more exhaustive case finding, improved case management and follow-up, and use of directly observed therapy (DOT).

UR - http://www.scopus.com/inward/record.url?scp=84870701113&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84870701113&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0051133

DO - 10.1371/journal.pone.0051133

M3 - Article

C2 - 23226479

AN - SCOPUS:84870701113

VL - 7

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 11

M1 - e51133

ER -