Tuberculosis in Immigrants to Cartagena de Indias, Colombia

Abstract

<strong>Introduction: </strong>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 <em>Mycobacterium tuberculosis </em>in the immigrant population of Cartagena de Indias, Colombia.<br /> <strong>Methods: </strong>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 <em>M. tuberculosis </em>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 <em>P</em>≤0.05.<br /> <strong>Results: </strong>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%; <em>P</em>=0.002). The immigrants also had a higher frequency of cases with resistance (15.22 vs. 44.44%; <em>P</em>=0.051) and undesired outcomes, such as therapeutic failure (8.70% vs. 33.33%; <em>P</em>=0.001) and death (4.35% vs. 44.44%; <em>P</em>=0.001).<br /> <strong>Conclusion: </strong>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.