{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T14:08:11Z","timestamp":1770818891568,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T00:00:00Z","timestamp":1620777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Cooperative Agreement","award":["U50CK00189"],"award-info":[{"award-number":["U50CK00189"]}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011015","name":"International Society of Travel Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011015","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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\u00a0days (interquartile range [IQR]: 10\u2013751\u00a0days); 34.3% of patients presented within 1\u00a0month after immigration, 30.9% between 1 and 12\u00a0months and 34.9% after \u22651\u00a0year. Pre-XDR- and XDR-TB patients from the former Soviet Union other than Georgia presented earlier than those with MDR-TB (26\u00a0days [IQR: 8\u2013522] vs. 369\u00a0days [IQR: 84\u2013827]), while patients from Georgia presented very early, irrespective of the level of resistance (8\u00a0days [IQR: 2\u201318] vs. 2\u00a0days [IQR: 1\u201317]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/taab069","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T19:21:48Z","timestamp":1620242508000},"source":"Crossref","is-referenced-by-count":15,"title":["Multidrug-resistant tuberculosis imported into low-incidence countries\u2014a GeoSentinel analysis, 2008\u20132020"],"prefix":"10.1093","volume":"28","author":[{"given":"Johannes","family":"Eimer","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calvin","family":"Patimeteeporn","sequence":"additional","affiliation":[{"name":"Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mogens","family":"Jensenius","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Oslo University Hospital, Ullev\u00e5l, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Effrossyni","family":"Gkrania-Klotsas","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Cambridge University Hospital NHS Trust, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Duvignaud","sequence":"additional","affiliation":[{"name":"Sant\u00e9-Voyages et M\u00e9decine tropicale - H\u00f4pital Saint-Andr\u00e9, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth D","family":"Barnett","sequence":"additional","affiliation":[{"name":"Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha S","family":"Hochberg","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin H","family":"Chen","sequence":"additional","affiliation":[{"name":"Travel Medicine Center - Mt. Auburn Hospital, Cambridge, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Trigo-Esteban","sequence":"additional","affiliation":[{"name":"Hospital Universitario La Paz-Carlos III, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Gertler","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine and International Health, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Greenaway","sequence":"additional","affiliation":[{"name":"Jewish General Hospital, Division of Infectious Diseases, Montreal, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin P","family":"Grobusch","sequence":"additional","affiliation":[{"name":"Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam, The Netherlands"},{"name":"Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina M","family":"Angelo","sequence":"additional","affiliation":[{"name":"Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davidson H","family":"Hamer","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA"},{"name":"Department of Global Health, Boston University School of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Caumes","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, AP-HP, H\u00f4pitaux Universitaires Piti\u00e9-Salp\u00eatri\u00e8re Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, 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