{"doi":"10.1093/jtm/taab069","title":"Multidrug-resistant tuberculosis imported into low-incidence countries—a GeoSentinel analysis, 2008–2020","abstract":"BACKGROUND: Early detection of imported multidrug-resistant tuberculosis (MDR-TB) is crucial, but knowledge gaps remain about migration- and travel-associated MDR-TB epidemiology. The aim was to describe epidemiologic characteristics among international travellers and migrants with MDR-TB. METHODS: Clinician-determined and microbiologically confirmed MDR-TB diagnoses deemed to be related to travel or migration were extracted from GeoSentinel, a global surveillance network of travel and tropical medicine clinics, from January 2008 through December 2020. MDR-TB was defined as resistance to both isoniazid and rifampicin. Additional resistance to either a fluoroquinolone or a second-line injectable drug was categorized as pre-extensively drug-resistant (pre-XDR) TB, and as extensively drug-resistant (XDR) TB when resistance was detected for both. Sub-analyses were performed based on degree of resistance and country of origin. RESULTS: Of 201 patients, 136 had MDR-TB (67.7%), 25 had XDR-TB (12.4%), 23 had pre-XDR TB (11.4%) and 17 had unspecified MDR- or XDR-TB (8.5%); 196 (97.5%) were immigrants, of which 92 (45.8%) originated from the former Soviet Union. The median interval from arrival to presentation was 154 days (interquartile range [IQR]: 10-751 days); 34.3% of patients presented within 1 month after immigration, 30.9% between 1 and 12 months and 34.9% after ≥1 year. Pre-XDR- and XDR-TB patients from the former Soviet Union other than Georgia presented earlier than those with MDR-TB (26 days [IQR: 8-522] vs. 369 days [IQR: 84-827]), while patients from Georgia presented very early, irrespective of the level of resistance (8 days [IQR: 2-18] vs. 2 days [IQR: 1-17]). CONCLUSIONS: MDR-TB is uncommon in traditional travellers. Purposeful medical migration may partly explain differences in time to presentation among different groups. Public health resources are needed to better understand factors contributing to cross-border MDR-TB spread and to develop strategies to optimize care of TB-infected patients in their home countries before migration.","journal":"Journal of Travel Medicine","year":2021,"id":187338,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":18,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8985,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":746847,"name":"Calvin Patimeteeporn","orcid":null,"position":1,"is_corresponding":false},{"id":746848,"name":"Mogens Jensenius","orcid":null,"position":2,"is_corresponding":false},{"id":746439,"name":"Effrossyni Gkrania‐Klotsas","orcid":"0000-0002-0930-8330","position":3,"is_corresponding":false},{"id":493449,"name":"Alexandre Duvignaud","orcid":"0000-0001-7139-2687","position":4,"is_corresponding":false},{"id":91700,"name":"Elizabeth D. Barnett","orcid":"0000-0003-4822-5949","position":5,"is_corresponding":false},{"id":261682,"name":"Natasha S. Hochberg","orcid":"0000-0002-5449-9973","position":6,"is_corresponding":false},{"id":261685,"name":"Lin H. Chen","orcid":"0000-0002-5684-8436","position":7,"is_corresponding":false},{"id":746440,"name":"Elena Trigo","orcid":"0000-0003-4085-7538","position":8,"is_corresponding":false},{"id":746441,"name":"Maximilian Gertler","orcid":"0000-0002-6384-9162","position":9,"is_corresponding":false},{"id":746442,"name":"Christina Greenaway","orcid":"0000-0002-9737-3326","position":10,"is_corresponding":false},{"id":236318,"name":"Martin P. Grobusch","orcid":"0000-0002-0046-1099","position":11,"is_corresponding":false},{"id":261679,"name":"Kristina M Angelo","orcid":"0000-0001-7665-7875","position":12,"is_corresponding":false},{"id":261694,"name":"Davidson H. Hamer","orcid":"0000-0002-4700-1495","position":13,"is_corresponding":false},{"id":746443,"name":"Éric Caumes","orcid":"0000-0002-0685-7262","position":14,"is_corresponding":false},{"id":445453,"name":"Hilmir Ásgeirsson","orcid":"0000-0003-3869-8021","position":15,"is_corresponding":false},{"id":746438,"name":"Johannes Eimer","orcid":"0000-0002-3351-8581","position":0,"is_corresponding":true}],"reference_count":27,"raw_metadata":null,"created_at":"2026-07-18T23:48:51.315888Z","pmid":"33987682","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}