Incidence of infectious diseases and survival among the Roma population: a longitudinal cohort study

• Published in: European journal of public health Vol. 22; no. 2; pp. 262 - 266
• Main Authors: Casals, Martí, Pila, Pilar, Langohr, Klaus, Millet, Juan-Pablo, Caylà, Joan A
• Format: Journal Article
• Language: English
• Published: England Oxford Publishing Limited (England) 01.04.2012
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - ethnology; Acquired Immunodeficiency Syndrome - mortality; Adolescent; Adult; Aged; Aged, 80 and over; Census; Child; Child, Preschool; Cohort analysis; Cohort Studies; Communicable diseases; Drug use; Ethnic groups; Ethnicity; Family; Family Relations; Female; Follow-Up Studies; Health policy; Humans; Imprisonment; Incidence; Infant; Infant, Newborn; Information sources; Injections; Investigation; Longitudinal Studies; Male; Men; Middle Aged; Multivariate analysis; Mycobacterium; Population; Prisoners - statistics & numerical data; Proportional Hazards Models; Registries; Retrospective Studies; Risk; Roma; Roma - ethnology; Romani people; Spain; Spain - epidemiology; Substance Abuse, Intravenous - ethnology; Substance Abuse, Intravenous - mortality; Surveys and Questionnaires; Survival analysis; Survival Rate; Tuberculosis; Tuberculosis, Pulmonary - ethnology; Tuberculosis, Pulmonary - mortality; Women; Young Adult; Spain; Catalonia Spain; Italy; Barcelona Spain; Rome Italy; Italy, Roma
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckq204

Roma ethnicity is greatly affected by tuberculosis (TB), AIDS, injecting drugs use (IDU) and imprisonment. We assessed the incidence of several health problems by means of a retrospective cohort study performed in Camp de la Bota, Barcelona (Spain). The 380 individuals included in the 1985 TB outbreak investigation were followed-up until 31 December 2008. One hundred ninety-two subjects (50.5%) were men and 188 (49.5%) women. Information sources included questionnaires taken at the time of this outbreak, a population census and other registries from Barcelona and Catalonia. Cox proportional hazards mixed models were employed in the multivariate survival analysis. By the end of the follow-up, the survival rate was 79.4%; 50 persons (13.1%) had deceased and 28 (7.3%) had emigrated. The incidence of AIDS was 104 cases per 100 000 person-years of follow-up (pyf), IDU was 240 cases pyf, imprisonment was 642 cases pyf and that of TB was 91 cases pyf. Male survival was lower [hazard ratio (HR) 4.22], when the effect of family was taken into account, than when it was not taken into account (HR 3.67). High incidences of AIDS, TB, IDU, imprisonment and poor survival rates have been observed among Roma. Family was found to be an important factor influencing the survival rates: when not considered, the risk of death among men was underestimated.