International Journal of Tuberculosis and Lung Disease
Volume 23, Issue 1, 2019, Pages 105-111

Paediatric tuberculosis among the foreign-born: Utility of the Canadian TB immigration medical surveillance programme (Article)

Yasseen A.S., III , Rea E. , Hirji M.M. , Yang C. , Alvarez G.G. , Khan K. , Kitai I.*
  • a Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
  • b Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Toronto Public Health, Tuberculosis Programme, Toronto, ON, Canada
  • c Niagara Region Public Health and Emergency Services, Thorold, ON, Canada, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
  • d Faculty of Medicine, University of Toronto, Toronto, ON, Canada
  • e Department of Medicine, Ottawa Hospital, Ottawa, ON, Canada, School of Public Health, University of Ottawa, Ottawa, ON, Canada
  • f Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada
  • g Department of Paediatrics, University of Toronto, Toronto, ON, Canada, Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada

Abstract

BACKGROUND: There are few data on the utility of screening paediatric immigrants for tuberculosis (TB) in low TB burden countries. OBJECTIVE: To evaluate the utility of the Canadian immigration medical examination and TB Medical Surveillance (TBMS) for detecting paediatric TB disease. DESIGN: A 10-year population-based retrospective cohort study of foreign-born children (ages 0–10 years) and adolescents (ages 11–17 years) immigrating to Ontario, Canada, using linked immigration and public health databases. RESULTS: Among 232 169 individuals (median followup of 5.7 years), active TB was diagnosed at or after immigration in 125 cases (20 children and 105 adolescents), at an overall rate of 54/100 000 (14/100 000 children, 116/100 000 adolescents). All cases originated from 34 countries. Active TB was diagnosed in 0/419 children and 10/418 adolescents referred for medical surveillance, representing only 8.0% of all cases. TBMS referrals were correlated with a previous diagnosis of TB (к = 0.8) and were driven by country of origin (e.g., hazard ratio 31.2 for the Philippines). Rates of pre-immigration TB diagnosis varied considerably among high TB burden countries. CONCLUSIONS: The current Canadian system detects little TB disease, and reveals very different rates of pre-immigration paediatric TB diagnosis in different high TB burden countries. These data provide a basis for improving TB screening strategies for immigrants to low TB burden countries. © 2019 The Union.

Author Keywords

Screening migrant Infectious diseases Paediatric

Index Keywords

Pakistan India medical examination immigration human priority journal disease surveillance lung tuberculosis male female population research Canadian Article major clinical study cohort analysis Bangladesh retrospective study disease burden Philippines public health Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85060373414&doi=10.5588%2fijtld.18.0317&partnerID=40&md5=960a79822fa7f549817e59ada39f3678
DOI: 10.5588/ijtld.18.0317
ISSN: 10273719
Original Language: English