Bone and joint tuberculosis in Denmark - Increase due to immigration

We studied the epidemiology of bone and joint tuberculosis (TB) in Denmark during the period 1993-1997, using data in the national Danish TB register. We found 95 cases, accounting for 4% of all tuberculosis cases and 15% of extrapulmonary cases, giving a mean annual incidence of 0.4 per 10(5) in th e period 26 cases were found among native Dana (3-8 cases per year) with a median age of 66 (10-92) years and giving a mean annual incidence of 0.1 pe r 10(5). Among immigrants, an increasing number of cases of bone and joint TB were diagnosed, increasing from 5 in 1993 to 28 in 1997, giving a total of 69 cases with a mean age of 35 (11-75) years and a mean annual incidence of 4 per 10(5) in the period. The spine was affected in half of the cases. 28 patients had active TB else where in the same period. In mast patients, there were no predisposing or r isk factors for disease except for ethnicity, Compared to a study of bone a nd joint TB in Denmark in the 1980s, the total incidence is the same, but t here has been a shift in patients from old Domes to young immigrants, The i ncreasing number of bone and joint TB cases among immigrants is due to rece nt immigration of Somalian refugees, who have a high incidence of TB and a high proportion of extrapulmonary TB, The diagnosis was often delayed sever al months or years. This study shows that attention must be paid to this co ndition, particularly in young patients from an endemic immigrant populatio n.