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

BACKGROUND

Roma ethnicity is greatly affected by tuberculosis (TB), AIDS, injecting drugs use (IDU) and imprisonment.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.