Associations between mental illness, TB risk and migrant status
BACKGROUND: TB and mental illnesses are public health priorities that often co-exist, with migrants in high-income countries being at risk for both conditions. This study investigates whether mental illness influences TB risk and examines the impact of migration status. METHODS: A nationwide prospec...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
International Union Against Tuberculosis and Lung Disease (The Union)
2024-12-01
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| Series: | IJTLD Open |
| Subjects: | |
| Online Access: | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000012/art00006 |
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| Summary: | BACKGROUND: TB and mental illnesses are public health priorities that often co-exist, with migrants in high-income countries being at risk for both conditions. This study investigates whether mental illness influences TB risk and examines the impact of migration status. METHODS: A nationwide prospective cohort study was conducted in Denmark from 1994–2015, involving migrants matched 1:6 to Danish-born individuals. Cox regression models, adjusted for age, sex and migrant status, were used to assess the effect of mental disorders on TB risk. RESULTS: Both migrants and non-migrants with mental disorders showed elevated TB incidence (n = 1,189,273). After adjusting for age and sex, the hazard ratio (HR) for TB in those with any mental disorder was 3.62 (95% CI 2.99–4.39, n < 0.001) compared to those without mental disorders. The effect was more substantial in Danish-born individuals (HR 15.51, 95% CI 12.05–19.95, n < 0.001) than in migrants (HR 1.37, 95% CI 0.99–1.90, n = 0.055). Sub-analyses highlighted a significant effect of substance use (HR 5.49, 95% CI 4.46–6.76, n < 0.001) and psychosis (HR 4.19, 95% CI 1.74–10.08, n = 0.001) and borderline significance for affective/anxiety/stress-related disorders (HR 1.64, 95% CI 0.98–2.73, n = 0.058) on TB risk. CONCLUSIONS: People with mental illnesses, particularly psychotic and substance use disorders, have increased TB incidence and represent a high-risk population for targeted screening and treatment. TB programmes should integrate holistic mental health care. |
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| ISSN: | 3005-7590 |