Extra-pulmonary TB: a comparison between migrants and populations born in a low-incidence country

BACKGROUNDThe proportion of TB cases attributable to extra-pulmonary TB (EPTB) is increasing in high-income countries, including England. We sought to describe the burden of EPTB in East London, an area with a large migrant population and high TB incidence.METHODSA retrospective analysis of individuals with TB was conducted and compared to national data.RESULTS1,262 patients were diagnosed with TB between 2016 and 2019. 52.7% had EPTB, 32.6% isolated pulmonary TB (PTB), and 14.7% concurrent disease. This compares to 43.8% of individuals nationally with isolated EPTB. In our cohort, of those with EPTB, 83.6% were non-UK-born (migrants). Multivariate analysis demonstrated that migrants had significantly higher odds of EPTB compared to UK-born individuals after adjusting for age and sex (adjusted odds ratio: 1.55, 95% confidence interval: 1.16–2.09, P = 0.003). Median time since entry to the UK among migrants who were diagnosed with EPTB was 11 years (interquartile range: 5–21). Treatment outcomes were worse in migrants with EPTB, mainly due to higher mortality.CONCLUSIONOur data reports a higher proportion of EPTB compared to national data. EPTB was more common in migrants than UK-born individuals.