Background. Canadian policy requires refugees with a history of tuberculosis (TB) or abnormal chest radiograph to be screened after arrival for TB. However, Tibetan refugees are indiscriminately screened, regardless of preimmigration assessment. We sought to determine the incidence of latent (LTBI) and active TB, as well as treatment-related outcomes and associations between preimmigration factors and TB infection among Tibetan refugees arriving in Calgary, Alberta. Design. Retrospective cohort study including Tibetan refugees arriving between 2014 and 2016. Associations between preimmigration factors and incidence of latent and active TB were determined using Chi-square tests. Results. Out of 180 subjects, 49 percent had LTBI. LTBI was more common in migrants 30 years of age or older (P=0.009). Treatment initiation and completion rates were high at 90 percent and 76 percent, respectively. No associations between preimmigration factors and treatment completion were found. A case of active TB was detected and treated. Conclusion. Within this cohort, the case of active TB would have been detected through the usual postsurveillance process due to a history of TB and abnormal chest radiograph. Forty-nine percent had LTBI, compared to previously quoted rates of 97 percent. Tibetan refugees should be screened for TB in a similar manner to other refugees resettling in Canada. © 2016 Rachel Lim et al.

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Tibet refugee mass screening abdominal pain human immigration Refugees comorbidity Cohort Studies statistics and numerical data interferon gamma release assay multidrug resistant tuberculosis Mycobacterium tuberculosis priority journal Interferon-gamma Release Tests ethnology rash liver enzyme screening drug hypersensitivity Young Adult diagnostic imaging Humans Sputum tuberculostatic agent Antitubercular Agents Lung Adolescent Tuberculosis, Pulmonary latent tuberculosis male Treatment Outcome Alberta tuberculosis female Incidence Article Retrospective Studies drug withdrawal major clinical study tuberculin test adult isoniazid age Amikacin thorax radiography Age Factors microbiology cohort analysis ethambutol retrospective study rifampicin levofloxacin bacterium culture pyrazinamide Radiography, Thoracic