Canadian Respiratory Journal
Volume 2016, 2016

A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic (Article) (Open Access)

Rennert-May E. , Hansen E. , Zadeh T. , Krinke V. , Houston S. , Cooper R.*
  • a Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada
  • b Edmonton TB Clinic, Edmonton, AB T6G 2J3, Canada
  • c Edmonton TB Clinic, Edmonton, AB T6G 2J3, Canada
  • d New Canadians Clinic, Edmonton, AB T5M 3Z7, Canada
  • e Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada, University of Alberta, School of Public Health, Edmonton, AB T6G 1C9, Canada
  • f Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada, Edmonton TB Clinic, Edmonton, AB T6G 2J3, Canada, University of Alberta, School of Public Health, Edmonton, AB T6G 1C9, Canada

Abstract

Objectives. Approximately 65 percent of tuberculosis (TB) cases in Canada each year occur from reactivation in foreign-born individuals. Refugees are at high risk after immigration. Routine screening of this population for latent TB infection (LTBI) is generally considered infeasible. We evaluated the outcome of LTBI screening and treatment amongst refugees. Methods. Government-sponsored refugees in Edmonton are seen at the New Canadians' Clinic and screened for TB and LTBI. We reviewed records of patients between 2009 and 2011. Completeness of initial assessment, diagnosis of latent infection, and completion of LTBI treatment were evaluated. Treatment for LTBI was offered when patients had a positive Tuberculin Skin Test (TST) and risk factors for progression to TB. An Interferon-Gamma Release Assay (IGRA) was performed on all other TST positives; treatment is only offered if it was positive. Results. 949 refugees were evaluated. 746 TSTs were read, with 265 positive individuals. IGRA testing was performed in 203 TST positive individuals without other TB risk factors; 110 were positive. LTBI treatment was offered to 147 of 151 eligible patients, 141 accepted, and 103 completed a treatment course. Conclusion. We observed high proportions of patient retention, completion of investigations, and treatment. This care model promises to be a component of effective TB prevention in this high-risk population. © 2016 Elissa Rennert-May et al.

Author Keywords

[No Keywords available]

Index Keywords

refugee mass screening human Refugees middle aged interferon gamma release assay Interferon-gamma Release Tests priority journal disease eradication screening Young Adult Humans Adolescent Antitubercular Agents Rifampin Canada tuberculostatic agent latent tuberculosis male female Alberta medical record Article major clinical study tuberculin test adult disease elimination isoniazid infection risk government ambulatory care outcome assessment hospital rifampicin Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84961785391&doi=10.1155%2f2016%2f7980869&partnerID=40&md5=9aae4734b517845c1e164706fcdb41fc
DOI: 10.1155/2016/7980869
ISSN: 11982241
Cited by: 9
Original Language: English