Evidence map›Paper›PMID 33987682›Full record

ArticleJournal of travel medicine2021

Multidrug-resistant tuberculosis imported into low-incidence countries-a GeoSentinel analysis, 2008-2020.

Johannes Eimer, Calvin Patimeteeporn, Mogens Jensenius, Effrossyni Gkrania-Klotsas, Alexandre Duvignaud, Elizabeth D Barnett, Natasha S Hochberg, Lin H Chen, Elena Trigo-Esteban, Maximilian Gertler and 6 more

Open access · bronzeAbstract read
In one paragraph

Article in Journal of travel medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.8field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 18 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Antimicrobial Resistance and Human Mobility.Infection and drug resistance · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 13 institutions in 8 countries.

Johannes EimerDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
Calvin PatimeteepornDivision of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Mogens JenseniusDepartment of Infectious Diseases, Oslo University Hospital, Ullevål, Oslo, Norway.
Effrossyni Gkrania-KlotsasDepartment of Infectious Diseases, Cambridge University Hospital NHS Trust, Cambridge, UK.
Alexandre DuvignaudSanté-Voyages et Médecine tropicale - Hôpital Saint-André, Bordeaux, France.
Elizabeth D BarnettMaxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, MA, USA.
Natasha S HochbergSection of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
Lin H ChenTravel Medicine Center - Mt. Auburn Hospital, Cambridge, MA, USA.
Elena Trigo-EstebanHospital Universitario La Paz-Carlos III, Madrid, Spain.
Maximilian GertlerInstitute of Tropical Medicine and International Health, Berlin, Germany.
Christina GreenawayJewish General Hospital, Division of Infectious Diseases, Montreal, Canada.
Martin P GrobuschCenter of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Kristina M AngeloDivision of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Davidson H HamerSection of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
Eric CaumesSorbonne Université, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France.
Hilmir AsgeirssonDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
Boston University · USCenters for Disease Control and Prevention · USBoston Medical Center · USCambridge University Hospitals NHS Foundation Trust · GBGGD Amsterdam · NLHôpital Saint-André · FRHospital Universitario La Paz · ESInserm · FRJewish General Hospital · CAKarolinska Institutet · SEKarolinska University Hospital · SEMount Auburn Hospital · USOslo University Hospital · NO

Funding

CDC HHSCooperative Agreement U50CK00189International Society of Travel MedicineIntramural CDC HHS CC999999Medical Research Council G0701652NCEZID CDC HHS U50 CK000189Public Health Agency of Canada
6 · The paper itself

Abstract

backgroundEarly detection of imported multidrug-resistant tuberculosis (MDR-TB) is crucial, but knowledge gaps remain about migration- and travel-associated MDR-TB epidemiology. The aim was to describe epidemiologic characteristics among international travellers and migrants with MDR-TB.

methodsClinician-determined and microbiologically confirmed MDR-TB diagnoses deemed to be related to travel or migration were extracted from GeoSentinel, a global surveillance network of travel and tropical medicine clinics, from January 2008 through December 2020. MDR-TB was defined as resistance to both isoniazid and rifampicin. Additional resistance to either a fluoroquinolone or a second-line injectable drug was categorized as pre-extensively drug-resistant (pre-XDR) TB, and as extensively drug-resistant (XDR) TB when resistance was detected for both. Sub-analyses were performed based on degree of resistance and country of origin.

resultsOf 201 patients, 136 had MDR-TB (67.7%), 25 had XDR-TB (12.4%), 23 had pre-XDR TB (11.4%) and 17 had unspecified MDR- or XDR-TB (8.5%); 196 (97.5%) were immigrants, of which 92 (45.8%) originated from the former Soviet Union. The median interval from arrival to presentation was 154 days (interquartile range [IQR]: 10-751 days); 34.3% of patients presented within 1 month after immigration, 30.9% between 1 and 12 months and 34.9% after ≥1 year. Pre-XDR- and XDR-TB patients from the former Soviet Union other than Georgia presented earlier than those with MDR-TB (26 days [IQR: 8-522] vs. 369 days [IQR: 84-827]), while patients from Georgia presented very early, irrespective of the level of resistance (8 days [IQR: 2-18] vs. 2 days [IQR: 1-17]).

conclusionsMDR-TB is uncommon in traditional travellers. Purposeful medical migration may partly explain differences in time to presentation among different groups. Public health resources are needed to better understand factors contributing to cross-border MDR-TB spread and to develop strategies to optimize care of TB-infected patients in their home countries before migration.

Indexed as

Extensively Drug-Resistant TuberculosisMycobacterium tuberculosisTuberculosis, Multidrug-ResistantAntitubercular AgentsHumansIncidenceTravelAntitubercular Agentsepidemiologyextensively drug-resistant tuberculosisimmigrationMDR-TBmedical migrationmigrantTravel

Identifiers

PMID33987682
PMCPMC9638878
OpenAlexW3163949887

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.