gms | German Medical Science

Kongress Medizin und Gesellschaft 2007

17. bis 21.09.2007, Augsburg

Influence of social interactions between Germans and non-Germans in the transmission of pulmonary tuberculosis in Baden-Württemberg, Germany

Meeting Abstract

  • Valérie Louis - Universität Heidelberg, Heidelberg
  • Judit Barniol - Universität Heidelberg, Heidelberg
  • Heiko Becher - Universität Heidelberg, Heidelberg
  • Walter Haas - Robert Koch Institute, Berlin
  • Stefan Niemann - Nationales Referenzzentrum für Mykobakterien, Borstel
  • Thomas Junghanss - Universität Heidelberg, Heidelberg

Kongress Medizin und Gesellschaft 2007. Augsburg, 17.-21.09.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gmds246

The electronic version of this article is the complete one and can be found online at:

Published: September 6, 2007

© 2007 Louis et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



In Germany, tuberculosis is a disease that affects disproportionately the migrant population with incidence rates in non-Germans being approximately five times higher than in Germans. The following study was proposed to shed light on the transmission dynamics within the migrant communities and between the German and migrant communities in Baden-Württemberg (BW).

In a three-year a prospective study (2003-2005), confirmed cases of pulmonary tuberculosis and their contact persons were identified through Public Health authorities in BW and asked to fill out a structured questionnaire focusing on social interactions between migrants and Germans. Based on this information an integration index was computed for migrants, i.e. individuals residing in but not born in Germany. Demographic and clinical information as well as molecular typing of tuberculosis strains were also collected for each study participant. Epidemiological and molecular typing methods were used to identify groups, named clusters, of at least two individuals infected by a common strain.

Among the 1284 cases of pulmonary tuberculosis recorded in BW during the study period, 742 (57.8%) were enrolled in the study. The profile of the study participants did not differ from that of the overall cases in BW in terms of sex, age, mortality linked to tuberculosis. The average incidence of pulmonary tuberculosis in BW during the study was 4.0/100,000. Considering nationality, the incidence rate was 2.6/100,000 for Germans and 14.6/100,000 for non-Germans. With increased time spent in Germany the value of the integration index of migrants increased and a trend was observed showing migrants more likely to belong to a migrant-German cluster rather than to a migrant-only cluster.

We conclude that social interactions play a role in the transmission of pulmonary tuberculosis in BW and a better understanding of those may help the development of targeted public health measures to improve tuberculosis control.