Roma TB patients –„double trouble”: migration and lifestyle

In a Roma community from Iasi County, Romania, TB incidence registered alarming peaks starting from 2009; the moment coincides with the increased migration „free of visa” of Romanian citizens. <b>Aim:</b> 25 years follow up of TB epidemiological process in a Roma community with an increasing population (1992- 131 persons, 2016-373), located at a periphery of a village. <b>Method:</b> Retrospective study of 14 TB cases notified 1991-2016. Demographic characteristics, treatment results, connection between cases were assessed in order to detect the place of transmission. <b>Results:</b> TB incidence registered peaks in this community in 2009- 1923%<b>₀₀₀</b>, in 2016- 804.3%<b>₀₀₀</b>, 8-15 times higher than in the general population. F/M:6/8, age: 9 months-46 years, pulmonary/extrapulmonary-11/3, smear positive at T<b>₀</b>- 10 cases. Drug resistance: 1 MDRTB, 1 H resistant. Treatment results: success- 71.4%, failure- 7.1%, default- 21.4%. 2 cases repeated defaults returning smear positive for retreatment, 1 lost from follow up. Half of cases travelled abroad (Italy, Spain, England, Germany, Sweden) more than once during TB treatment. Most of cases registered 2009-2016 were close relatives (children, siblings). Regarding place of transmission:one case with repeated defaults was the host of the evening meetings for food and chat in a small, overcrowded kitchen. <b>Conclusions:</b> –The TB incidence and infectiousness of cases from this Roma community are significantly higher than in general population; –The abroad movement of cases even during treatment is a potential factor of TB spreading in the general population and in similar communities from EU because of keeping the same life style and habits; –Persistent health care education is needed in this vulnerable group.