Time from arrival in Chile to tuberculosis diagnosis in migrants treated at primary care centers in two Metropolitan Region municipalities, Chile.

IF 0.8 Q2 MEDICINE, GENERAL & INTERNAL

Medwave Pub Date : 2025-08-06 DOI:10.5867/medwave.2025.07.3088

Alejandra Puga-Arriagada, Jhonatan Castro Horna, Marinella Mazzei Pimentel, Gabriel Cavada Chacón, Guillermo Sequera, Javiera Varela-Torres, Olivia Horna-Campos

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引用次数: 0

Abstract

Introduction: In Chile, the number of migrants affected by tuberculosis has experienced a significant increase from 7.1% in 2014 to 29.7% in 2023, ranking as the first group at risk. The objective was to estimate the time to diagnosis of tuberculosis from arrival in Chile in a series of migrants undergoing treatment between January 2021 and March 2022.

Methods: We analyzed a cohort of migrants over 18 years of age with a diagnosis of tuberculosis treated in the communes of Recoleta and Independencia. Those who agreed to participate and signed the informed consent form were included. Cases with non-tuberculous mycobacteria and residents outside the Metropolitan Region were excluded. Sociodemographic, clinical, and arrival dates, as well as symptoms and diagnoses, were recorded. Proportional hazards models in STATA v.18 were used to analyze times according to independent variables. A p value < 0.05 was considered significant.

Results: The median time to diagnosis was 93.5 months, varying by subgroup. The recent migration subgroup without Chilean documentation had a hazard ratio of 13.1, which indicates that, at any time after arrival, these individuals have a 13-fold increased risk of tuberculosis diagnosis compared to the reference subgroup (traditional migration with Chilean identity documents). This hazard ratio is reduced by 2.4 times when these types of migrants have documentation from Chile (95% confidence interval: 1.2 to 4.5).

Conclusions: There is a wide range of time from arrival in Chile to the diagnosis of tuberculosis. Factors such as the type of migration and the type of identity document have an impact on the development of this disease. It is necessary to expedite the legal administrative process for migrants and implement timely screening policies, along with follow-up and improved access to healthcare, to reduce exposure and risk of tuberculosis.

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移民从抵达智利到在智利两个大都市区的初级保健中心接受治疗的结核病诊断时间。

在智利，受结核病影响的移民人数从2014年的7.1%显著增加到2023年的29.7%，成为第一大风险群体。目的是估计2021年1月至2022年3月期间接受治疗的一系列移民从抵达智利到诊断出结核病所需的时间。方法：我们分析了在Recoleta和Independencia社区诊断为结核病的18岁以上移民队列。同意参与并签署知情同意书的人员均包括在内。非结核分枝杆菌病例和首都地区以外的居民被排除在外。记录社会人口学、临床和到达日期，以及症状和诊断。采用STATA v.18中的比例风险模型，根据自变量分析时间。p值< 0.05被认为是显著的。结果：中位诊断时间为93.5个月，各亚组差异较大。没有智利身份证件的最近移民亚组的风险比为13.1，这表明，在抵达后的任何时间，这些人患结核病的风险比参考亚组（具有智利身份证件的传统移民）增加了13倍。当这类移民拥有智利的证件时，这一风险比降低了2.4倍（95%置信区间：1.2至4.5）。结论：从抵达智利到被诊断为结核病的时间跨度很大。移民类型和身份证件类型等因素对这种疾病的发展有影响。有必要加快移民的法律行政程序，及时实施筛查政策，同时采取后续行动并改善获得医疗保健的机会，以减少接触结核病和患结核病的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medwave MEDICINE, GENERAL & INTERNAL-

CiteScore

2.60

自引率

8.30%

发文量

审稿时长

12 weeks

期刊介绍： Medwave is a peer-reviewed, biomedical and public health journal. Since its foundation in 2001 (Volume 1) it has always been an online only, open access publication that does not charge subscription or reader fees. Since January 2011 (Volume 11, Number 1), all articles are peer-reviewed. Without losing sight of the importance of evidence-based approach and methodological soundness, the journal accepts for publication articles that focus on providing updates for clinical practice, review and analysis articles on topics such as ethics, public health and health policy; clinical, social and economic health determinants; clinical and health research findings from all of the major disciplines of medicine, medical science and public health. The journal does not publish basic science manuscripts or experiments conducted on animals. Until March 2013, Medwave was publishing 11-12 numbers a year. Each issue would be posted on the homepage on day 1 of each month, except for Chile’s summer holiday when the issue would cover two months. Starting from April 2013, Medwave adopted the continuous mode of publication, which means that the copyedited accepted articles are posted on the journal’s homepage as they are ready. They are then collated in the respective issue and included in the Past Issues section.