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HIV and tuberculosis co-infection among migrants in Europe: A systematic review on the prevalence, incidence and mortality

Identifieur interne : 002970 ( Pmc/Curation ); précédent : 002969; suivant : 002971

HIV and tuberculosis co-infection among migrants in Europe: A systematic review on the prevalence, incidence and mortality

Auteurs : Ana Maria Tavares ; Inês Fronteira ; Isabel Couto ; Diana Machado ; Miguel Viveiros ; Ana B. Abecasis ; S Nia Dias

Source :

RBID : PMC:5619775

Abstract

Background

International human migration has been rapidly growing. Migrants coming from low and middle income countries continue to be considerably vulnerable and at higher risk for infectious diseases, namely HIV (Human Immunodeficiency Virus) and tuberculosis (TB). In Europe, the number of patients with HIV-TB co-infection has been increasing and migration could be one of the potential driving forces.

Objective

This systematic review aims to improve the understanding on the burden of HIV-TB co-infection among migrants in Europe and to assess whether these populations are particularly vulnerable to this co-infection compared to nationals.

Design

MEDLINE®, Web of Science® and Scopus® databases were searched from March to April 2016 using combinations of keywords. Titles and abstracts were screened and studies meeting the inclusion criteria proceeded for full-text revision. These articles were then selected for data extraction on the prevalence, incidence and mortality.

Results

The majority of HIV-TB prevalence data reported in the analysed studies, including extrapulmonary/disseminated TB forms, was higher among migrant vs. nationals, some of the studies even showing increasing trends over time. Additionally, while HIV-TB incidence rates have decreased among migrants and nationals, migrants are still at a higher risk for this co-infection. Migrants with HIV-TB co-infection were also more prone to unsuccessful treatment outcomes, death and drug resistant TB. However, contradicting results also showed lower mortality compared to nationals.

Conclusions

Overall, a disproportionate vulnerability of migrants to acquire the HIV-TB co-infection was observed across studies. Such vulnerability has been associated to low socioeconomic status, poor living conditions and limited access to healthcare. Adequate social support, early detection, appropriate treatment, and adequate access to healthcare are key improvements to tackle HIV-TB co-infection among these populations.


Url:
DOI: 10.1371/journal.pone.0185526
PubMed: 28957400
PubMed Central: 5619775

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PMC:5619775

Le document en format XML

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<p>International human migration has been rapidly growing. Migrants coming from low and middle income countries continue to be considerably vulnerable and at higher risk for infectious diseases, namely HIV (Human Immunodeficiency Virus) and tuberculosis (TB). In Europe, the number of patients with HIV-TB co-infection has been increasing and migration could be one of the potential driving forces.</p>
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<p>This systematic review aims to improve the understanding on the burden of HIV-TB co-infection among migrants in Europe and to assess whether these populations are particularly vulnerable to this co-infection compared to nationals.</p>
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<title>Design</title>
<p>MEDLINE
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, Web of Science
<sup>®</sup>
and Scopus
<sup>®</sup>
databases were searched from March to April 2016 using combinations of keywords. Titles and abstracts were screened and studies meeting the inclusion criteria proceeded for full-text revision. These articles were then selected for data extraction on the prevalence, incidence and mortality.</p>
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<title>Results</title>
<p>The majority of HIV-TB prevalence data reported in the analysed studies, including extrapulmonary/disseminated TB forms, was higher among migrant vs. nationals, some of the studies even showing increasing trends over time. Additionally, while HIV-TB incidence rates have decreased among migrants and nationals, migrants are still at a higher risk for this co-infection. Migrants with HIV-TB co-infection were also more prone to unsuccessful treatment outcomes, death and drug resistant TB. However, contradicting results also showed lower mortality compared to nationals.</p>
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<title>Conclusions</title>
<p>Overall, a disproportionate vulnerability of migrants to acquire the HIV-TB co-infection was observed across studies. Such vulnerability has been associated to low socioeconomic status, poor living conditions and limited access to healthcare. Adequate social support, early detection, appropriate treatment, and adequate access to healthcare are key improvements to tackle HIV-TB co-infection among these populations.</p>
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<role content-type="http://credit.casrai.org/">Methodology</role>
<role content-type="http://credit.casrai.org/">Writing – original draft</role>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff001"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Couto</surname>
<given-names>Isabel</given-names>
</name>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff001"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Machado</surname>
<given-names>Diana</given-names>
</name>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff001"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Viveiros</surname>
<given-names>Miguel</given-names>
</name>
<role content-type="http://credit.casrai.org/">Methodology</role>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff001"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Abecasis</surname>
<given-names>Ana B.</given-names>
</name>
<role content-type="http://credit.casrai.org/">Methodology</role>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff001"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dias</surname>
<given-names>Sónia</given-names>
</name>
<role content-type="http://credit.casrai.org/">Conceptualization</role>
<role content-type="http://credit.casrai.org/">Methodology</role>
<role content-type="http://credit.casrai.org/">Supervision</role>
<role content-type="http://credit.casrai.org/">Writing – original draft</role>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="corresp" rid="cor001">*</xref>
<xref ref-type="aff" rid="aff001"></xref>
</contrib>
</contrib-group>
<aff id="aff001">
<addr-line>Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisboa, Portugal</addr-line>
</aff>
<contrib-group>
<contrib contrib-type="editor">
<name>
<surname>Ciccozzi</surname>
<given-names>Massimo</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">
<addr-line>National Institute of Health, ITALY</addr-line>
</aff>
<author-notes>
<fn fn-type="COI-statement" id="coi001">
<p>
<bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<corresp id="cor001">* E-mail:
<email>SFDias@ihmt.unl.pt</email>
(SD);
<email>ana.tavares@ihmt.unl.pt</email>
(AMT)</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>28</day>
<month>9</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection">
<year>2017</year>
</pub-date>
<volume>12</volume>
<issue>9</issue>
<elocation-id>e0185526</elocation-id>
<history>
<date date-type="received">
<day>26</day>
<month>5</month>
<year>2017</year>
</date>
<date date-type="accepted">
<day>14</day>
<month>9</month>
<year>2017</year>
</date>
</history>
<permissions>
<copyright-statement>© 2017 Tavares et al</copyright-statement>
<copyright-year>2017</copyright-year>
<copyright-holder>Tavares et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open access article distributed under the terms of the
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="pone.0185526.pdf"></self-uri>
<abstract>
<sec id="sec001">
<title>Background</title>
<p>International human migration has been rapidly growing. Migrants coming from low and middle income countries continue to be considerably vulnerable and at higher risk for infectious diseases, namely HIV (Human Immunodeficiency Virus) and tuberculosis (TB). In Europe, the number of patients with HIV-TB co-infection has been increasing and migration could be one of the potential driving forces.</p>
</sec>
<sec id="sec002">
<title>Objective</title>
<p>This systematic review aims to improve the understanding on the burden of HIV-TB co-infection among migrants in Europe and to assess whether these populations are particularly vulnerable to this co-infection compared to nationals.</p>
</sec>
<sec id="sec003">
<title>Design</title>
<p>MEDLINE
<sup>®</sup>
, Web of Science
<sup>®</sup>
and Scopus
<sup>®</sup>
databases were searched from March to April 2016 using combinations of keywords. Titles and abstracts were screened and studies meeting the inclusion criteria proceeded for full-text revision. These articles were then selected for data extraction on the prevalence, incidence and mortality.</p>
</sec>
<sec id="sec004">
<title>Results</title>
<p>The majority of HIV-TB prevalence data reported in the analysed studies, including extrapulmonary/disseminated TB forms, was higher among migrant vs. nationals, some of the studies even showing increasing trends over time. Additionally, while HIV-TB incidence rates have decreased among migrants and nationals, migrants are still at a higher risk for this co-infection. Migrants with HIV-TB co-infection were also more prone to unsuccessful treatment outcomes, death and drug resistant TB. However, contradicting results also showed lower mortality compared to nationals.</p>
</sec>
<sec id="sec005">
<title>Conclusions</title>
<p>Overall, a disproportionate vulnerability of migrants to acquire the HIV-TB co-infection was observed across studies. Such vulnerability has been associated to low socioeconomic status, poor living conditions and limited access to healthcare. Adequate social support, early detection, appropriate treatment, and adequate access to healthcare are key improvements to tackle HIV-TB co-infection among these populations.</p>
</sec>
</abstract>
<funding-group>
<funding-statement>This study was funded by the Portuguese Foundation for Science and Technology (Fundação para a Ciência e a Tecnologia - FCT,
<ext-link ext-link-type="uri" xlink:href="http://www.FCT.pt">www.FCT.pt</ext-link>
), through funds to the Global Health and Tropical Medicine Research Center (GHTM - UID/Multi/04413/2013) and through the project ‘MigrantHIV: Genomics, socio-behavioral and clinical data to prevent HIV transmission in migrants: an innovative approach’ (PTDC/DTP-EPI/7066/2014). This study was supported by funds of the GHTM, through the project “Characterization of Drug-Resistant TB and HIV, and Associated Socio-Behavioural Factors Among Migrants in Lisbon, Portugal”. AMT and DM were supported by FCT: grants PD/BD/105916/2014 and SFRH/BPD/100688/2014, respectively. ABA was funded by the Investigador FCT programme. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts>
<fig-count count="1"></fig-count>
<table-count count="2"></table-count>
<page-count count="16"></page-count>
</counts>
<custom-meta-group>
<custom-meta id="data-availability">
<meta-name>Data Availability</meta-name>
<meta-value>All relevant data are within the paper and its Supporting Information files.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes>
<title>Data Availability</title>
<p>All relevant data are within the paper and its Supporting Information files.</p>
</notes>
</front>
</pmc>
</record>

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