Skip to main content
Thorax logoLink to Thorax
. 1991 Jan;46(1):1–5. doi: 10.1136/thx.46.1.1

Risk of tuberculosis in immigrant Asians: culturally acquired immunodeficiency?

P J Finch 1, F J Millard 1, J D Maxwell 1
PMCID: PMC1020904  PMID: 1871690

Abstract

Study of the 620 Asian immigrants with tuberculosis notified in the Wandsworth area of south London between 1973 and 1988 showed a bimodal pattern of tuberculosis notifications: in 1977 there was a peak among Asians from East Africa, and in 1981 a peak among those from the Indian subcontinent. There was a mean lag time of five years between clinical presentation and immigration. Logit analysis showed that, although overall more men had tuberculosis than women, glandular tuberculosis was more common among women of all groups, and pulmonary tuberculosis was more common among Hindu women than Hindu men. Both subgroups of Asians had a substantially higher incidence of tuberculosis than white people, particularly at extrapulmonary sites. Hindus were also at a significantly greater risk of tuberculosis at all sites than Muslims (Hindu:Muslim risk ratio 5.5 for women and 3.7 for men). The increased susceptibility to tuberculosis of Hindus, particularly Hindu women, may be related to a culturally acquired immunodeficiency caused by vegetarianism and associated vitamin deficiency.

Full text

PDF
1

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bar-Shavit Z., Noff D., Edelstein S., Meyer M., Shibolet S., Goldman R. 1,25-dihydroxyvitamin D3 and the regulation of macrophage function. Calcif Tissue Int. 1981;33(6):673–676. doi: 10.1007/BF02409507. [DOI] [PubMed] [Google Scholar]
  2. Chanarin I., Stephenson E. Vegetarian diet and cobalamin deficiency: their association with tuberculosis. J Clin Pathol. 1988 Jul;41(7):759–762. doi: 10.1136/jcp.41.7.759. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Davies P. D. A possible link between vitamin D deficiency and impaired host defence to Mycobacterium tuberculosis. Tubercle. 1985 Dec;66(4):301–306. doi: 10.1016/0041-3879(85)90068-6. [DOI] [PubMed] [Google Scholar]
  4. Dent C. E., Gupta M. M. Plasma 25-hydroxyvitamin-D-levels during pregnancy in Caucasians and in vegetarian and non-vegetarian Asians. Lancet. 1975 Nov 29;2(7944):1057–1060. doi: 10.1016/s0140-6736(75)90430-4. [DOI] [PubMed] [Google Scholar]
  5. Donaldson L. J., Taylor J. B. Patterns of Asian and non-Asian morbidity in hospitals. Br Med J (Clin Res Ed) 1983 Mar 19;286(6369):949–951. doi: 10.1136/bmj.286.6369.949. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fraser S. M. Ethnic differences in consultation rates. BMJ. 1989 Nov 11;299(6709):1220–1220. doi: 10.1136/bmj.299.6709.1220-d. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gardner M. J., Altman D. G. Confidence intervals rather than P values: estimation rather than hypothesis testing. Br Med J (Clin Res Ed) 1986 Mar 15;292(6522):746–750. doi: 10.1136/bmj.292.6522.746. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Gillam S. J., Jarman B., White P., Law R. Ethnic differences in consultation rates in urban general practice. BMJ. 1989 Oct 14;299(6705):953–957. doi: 10.1136/bmj.299.6705.953. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Harries A. D. Tuberculosis and human immunodeficiency virus infection in developing countries. Lancet. 1990 Feb 17;335(8686):387–390. doi: 10.1016/0140-6736(90)90216-r. [DOI] [PubMed] [Google Scholar]
  10. Henderson J. B., Dunnigan M. G., McIntosh W. B., Abdul-Motaal A. A., Gettinby G., Glekin B. M. The importance of limited exposure to ultraviolet radiation and dietary factors in the aetiology of Asian rickets: a risk-factor model. Q J Med. 1987 May;63(241):413–425. [PubMed] [Google Scholar]
  11. Hunt S. P., O'Riordan J. L., Windo J., Truswell A. S. Vitamin D status in different subgroups of British Asians. Br Med J. 1976 Dec 4;2(6048):1351–1354. doi: 10.1136/bmj.2.6048.1351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lowrie D. B., Andrew P. W. Macrophage antimycobacterial mechanisms. Br Med Bull. 1988 Jul;44(3):624–634. doi: 10.1093/oxfordjournals.bmb.a072272. [DOI] [PubMed] [Google Scholar]
  13. McCarthy O. R. Asian immigrant tuberculosis--the effect of visiting Asia. Br J Dis Chest. 1984 Jul;78(3):248–253. [PubMed] [Google Scholar]
  14. Morris J. A., Gardner M. J. Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. Br Med J (Clin Res Ed) 1988 May 7;296(6632):1313–1316. doi: 10.1136/bmj.296.6632.1313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Rook G. A. The role of vitamin D in tuberculosis. Am Rev Respir Dis. 1988 Oct;138(4):768–770. doi: 10.1164/ajrccm/138.4.768. [DOI] [PubMed] [Google Scholar]
  16. Shaunak S., Lakhani S. R., Abraham R., Maxwell J. D. Differences among Asian patients. Br Med J (Clin Res Ed) 1986 Nov 1;293(6555):1169–1169. doi: 10.1136/bmj.293.6555.1169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Skacel P. O., Chanarin I. Impaired chemiluminescence and bactericidal killing by neutrophils from patients with severe cobalamin deficiency. Br J Haematol. 1983 Oct;55(2):203–215. doi: 10.1111/j.1365-2141.1983.tb01240.x. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES