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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| Format: | Article |
| Language: | English |
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International Union Against Tuberculosis and Lung Disease (The Union)
2024-12-01
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| Series: | IJTLD Open |
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| Online Access: | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000012/art00006 |
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| author | S.E. Hayward K.L. Kristensen A. Deal J.H. Petersen T. Lillebaek S. Hargreaves M. Norredam J.S. Friedland |
| author_facet | S.E. Hayward K.L. Kristensen A. Deal J.H. Petersen T. Lillebaek S. Hargreaves M. Norredam J.S. Friedland |
| author_sort | S.E. Hayward |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-ec293bbdc8154a90a8402d2a1733a8f3 |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-ec293bbdc8154a90a8402d2a1733a8f32025-01-23T13:29:23ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-12-0111256457010.5588/ijtldopen.24.02606Associations between mental illness, TB risk and migrant statusS.E. Hayward0K.L. Kristensen1A. Deal2J.H. Petersen3T. Lillebaek4S. Hargreaves5M. Norredam6J.S. Friedland7Institute for Infection and Immunity, School of Health and Medical Sciences, City St George’s, University of London, London, UK;International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark;Institute for Infection and Immunity, School of Health and Medical Sciences, City St George’s, University of London, London, UK;Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark;Institute for Infection and Immunity, School of Health and Medical Sciences, City St George’s, University of London, London, UK;Danish Research Centre for Migration, Ethnicity and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;Institute for Infection and Immunity, School of Health and Medical Sciences, City St George’s, University of London, London, UK;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.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000012/art00006tuberculosismental healthmigrantcohorteurope |
| spellingShingle | S.E. Hayward K.L. Kristensen A. Deal J.H. Petersen T. Lillebaek S. Hargreaves M. Norredam J.S. Friedland Associations between mental illness, TB risk and migrant status IJTLD Open tuberculosis mental health migrant cohort europe |
| title | Associations between mental illness, TB risk and migrant status |
| title_full | Associations between mental illness, TB risk and migrant status |
| title_fullStr | Associations between mental illness, TB risk and migrant status |
| title_full_unstemmed | Associations between mental illness, TB risk and migrant status |
| title_short | Associations between mental illness, TB risk and migrant status |
| title_sort | associations between mental illness tb risk and migrant status |
| topic | tuberculosis mental health migrant cohort europe |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000012/art00006 |
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