European Respiratory Journal
Volume 38, Issue 4, 2011, Pages 895-902

Piecing the puzzle together: Foreign-born tuberculosis in an immigrant-receiving country (Article) (Open Access)

Langlois-Klassen D. , Wooldrage K.M. , Manfreda J. , Sutherland K. , Ellis E. , Phypers M. , Gushulak B. , Long R.*
  • a Department of Public Health Sciences, University of Alberta, Edmonton, AB, Canada, Tuberculosis Program Evaluation and Research Unit, University of Alberta, Aberhart Hospital, 11402 University Avenue, Edmonton AB T6G 2J3, Canada
  • b Dept. of Medicine, University of Manitoba, Winnipeg, MB, Canada
  • c Dept. of Medicine, University of Manitoba, Winnipeg, MB, Canada
  • d Tuberculosis Program Evaluation and Research Unit, University of Alberta, Aberhart Hospital, 11402 University Avenue, Edmonton AB T6G 2J3, Canada
  • e Community Acquired Infections Division, Public Health Agency of Canada, Ottawa, ON, Canada
  • f Community Acquired Infections Division, Public Health Agency of Canada, Ottawa, ON, Canada
  • g Migration Health Consultants, Inc., Cheltenham, ON, Canada
  • h Department of Public Health Sciences, University of Alberta, Edmonton, AB, Canada, Department of Medicine, University of Alberta, Edmonton, AB, Canada, Tuberculosis Program Evaluation and Research Unit, University of Alberta, Aberhart Hospital, 11402 University Avenue, Edmonton AB T6G 2J3, Canada

Abstract

In major immigrant-receiving countries, annual foreign-born tuberculosis (TB) case counts and rates are relatively constant. Why this is so, and who might be a high-yield target for screening for latent TB infection, remain open questions. Foreign-born TB in Canada during 1986-2002 was retrospectively examined using national TB and immigration data as well as census data. Case counts and rates were analysed in relation to demographics, immigration period and time since arrival. Pre-1986 immigrants (n=3,860,853) and 1986-2002 immigrants (n=3,463,283) contributed 8,662 and 9,613 TB cases, respectively. Immigrants arriving ≤5 yrs ago and those arriving >10 yrs ago contributed almost equally to the annual foreign-born TB case count despite a 3.5-fold difference in in-country person-yrs. Remarkably stable and relatively low TB incidence was observed among immigrants >10 yrs post-arrival. Conversely, TB incidence within 5 yrs of arrival was dynamic, demonstrating a strong inverse association with time since arrival and higher sensitivity to changes in immigration level than shifts toward higher incidence source countries. Relative constancy in foreign-born TB incidence is explained by a complex convergence of several factors. Immigrants born in high-incidence countries who arrived ≤2 yrs ago and were aged 15-34 yrs upon arrival constitute high-yield targets for preventive therapy. Copyright©ERS 2011.

Author Keywords

Foreign-born tuberculosis Epidemiology immigrants

Index Keywords

immigrant human immigration middle aged controlled study priority journal Aged Young Adult Humans Adolescent male Canada Tuberculosis, Pulmonary Emigrants and Immigrants female tuberculosis Risk Factors Incidence Article Retrospective Studies major clinical study adult Censuses age distribution world health organization retrospective study
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-80053541001&doi=10.1183%2f09031936.00196610&partnerID=40&md5=18f63ccb9b9c70c02764bd1231c611bb
DOI: 10.1183/09031936.00196610
ISSN: 09031936
Cited by: 29
Original Language: English