臺灣新住民潛伏結核感染：2016-2020結核病個案接觸者橫斷面研究

Latent Tuberculosis Infection Among New Immigrant in Taiwan: A Cross-Sectional Study of Tuberculosis Contacts, 2016–2020

研究顯示高收入國家的結核病(Tuberculosis ; TB)流行病學多呈現本國人發生率下降或維持低發生率，但在國外出生者(foreign-born)發生率卻呈上升趨勢或高於本國人。在部分結核病發生率低的先進國家甚至可明顯看到，來自結核病高負擔國家的移民有較高的發生率、死亡率及潛伏結核感染(Latent TB Infection, LTBI)率。
本研究為瞭解國人及新住民結核病個案接觸者LTBI檢驗結果的差異，蒐集結核病資料庫2016年1月至2020年6月通報確診之58,047名15–49歲身分別與性別完整建檔之育齡女性接觸者（本國籍38,674名，新住民388名），再依其與指標個案之關係（共同居住接觸者或職場接觸者），以邏輯斯回歸分析影響LTBI檢驗結果的因子，結果顯示育齡新住民女性，如為指標個案的共同居住者，LTBI檢驗陽性的風險顯著高於本國籍育齡女性(27.8% vs. 14.5%, aOR: 2.08; 95% CI: 1.55–2.78)；另育齡新住民女性如為指標個案的職場接觸者，LTBI檢驗陽性的風險也顯著高於本國籍女性(29.3% vs. 7.4%, aOR: 4.62; 95% CI: 3.18–6.72)。
研究顯示育齡新住民女性的潛伏結核感染率顯著高於本國籍育齡女性，與指標是否共同居住無關，為避免其日後結核病發病及造成傳播，應評估對來自結核病發生高負擔國家之新住民提供LTBI檢驗與預防性治療。

Based on the literature review, the distribution of tuberculosis (TB) cases in high-income countries mostly showed a continuous decline in domestic cases or maintained a low incidence rate. However, the incidence of TB in foreign-born people had increased or remained higher than domestic cases. In some advanced countries with a low incidence of TB, it is even more apparent to recognize that immigrants from TB high burden countries have a relatively higher incidence, mortality, and latent TB infection (LTBI) rate.
The 58,047 childbearing females of age between 15–49 years old contacts (38,674 contacts of Taiwanese and 388 contacts of new immigrants) who were in the TB database from 2016 to June 2020 with complete identity and gender information were analyzed for the results of the Interferon-γ-release assay (IGRA) test. In terms of the prevalence of LTBI, the contact of new immigrants as index cases’cohabitants had a higher risk of having IGRA-positive than Taiwanese counterparts (27.8% vs. 14.5%, aOR: 2.08; 95% CI: 1.55–2.78); the contacts of new-immigrants as index cases’colleague also had a higher possibility to have IGRA-positive than Taiwanese (29.3% vs. 7.4%, aOR: 4.62; 95% CI: 3.18–6.72).
According to the result of this study, compared to Taiwanese women of the same age (15–49 years old), the prevalence of LTBI among new-immigrant women was higher. We need to consider whether to refer to the WHO recommendations to provide latent tuberculosis infection screening and preventive treatment services for new immigrants from countries with a high burden of tuberculosis to avoid future diseases.