Journal of Infection and Public Health
Volume 3, Issue 2, 2010, Pages 67-75

Evaluation of a school-based program for diagnosis and treatment of latent tuberculosis infection in immigrant children (Article) (Open Access)

Minodier P. , Lamarre V. , Carle M.-E. , Blais D. , Ovetchkine P. , Tapiero B.*
  • a Infectious Diseases Division, Department of Pediatrics, CHU Sainte Justine - Université de Montréal, 3175 Côte Sainte Catherine, Montréal, Que. H3T 1C5, Canada, Pediatric Emergency, CHU Nord, Chemin des Bourrelly, 13015 Marseille, France
  • b Infectious Diseases Division, Department of Pediatrics, CHU Sainte Justine - Université de Montréal, 3175 Côte Sainte Catherine, Montréal, Que. H3T 1C5, Canada
  • c Intercultural Pediatric Unit, Department of Pediatrics, CHU Sainte Justine - Université de Montréal, 3175 Côte Sainte Catherine, Montréal, Que. H3T 1C5, Canada
  • d Infectious Diseases Division, Department of Pediatrics, CHU Sainte Justine - Université de Montréal, 3175 Côte Sainte Catherine, Montréal, Que. H3T 1C5, Canada
  • e Infectious Diseases Division, Department of Pediatrics, CHU Sainte Justine - Université de Montréal, 3175 Côte Sainte Catherine, Montréal, Que. H3T 1C5, Canada
  • f Infectious Diseases Division, Department of Pediatrics, CHU Sainte Justine - Université de Montréal, 3175 Côte Sainte Catherine, Montréal, Que. H3T 1C5, Canada, Intercultural Pediatric Unit, Department of Pediatrics, CHU Sainte Justine - Université de Montréal, 3175 Côte Sainte Catherine, Montréal, Que. H3T 1C5, Canada

Abstract

Objective: To evaluate a 10-year school-based latent tuberculosis infection (LTBI) screening program, targeting immigrant children in Montreal, Canada, and to identify predictive factors for refusal and, poor adherence to treatment. Methods: Immigrant children were screened for LTBI with Tuberculin Skin Test (TST). Isoniazid was, given when LTBI was diagnosed. Predictors of LTBI, of refusal of follow-up and treatment and of poor, adherence to isoniazid were analyzed. Results: Four thousand three hundred and seventy-five children were offered screening, 82.3% consented to TST and 22.8% were positive. An, older age at migration (odds ratio (OR) = 1 [95% CI: 1.0-1.01]), as well as migration from a none, established market economy country (OR varying from 2.41 to 4.23) were significantly associated with, positive TST. Among positive children, further evaluation was refused in 5.7%, mainly in migrants from, Eastern Europe (OR = 4.05 [95% CI: 2.14-7.69]). Refusal of treatment (11.2%) was more frequent in, Eastern European when compared to South-eastern Asian (OR = 6.91 [95% CI: 1.56-30.75]), in, blended families (OR = 3.25 [95% CI: 1.25-8.46]) and when the first visit to hospital was delayed (OR = 1.01 [95% CI: 1.0-1.02]). Adequate completion of treatment was noted in 61.3%. Age > 16 years (OR = 1.82 [95% CI: 1.82-2.99]), a delay between TST and first visit > 15 days (OR = 1.6 [95% CI: 1.12-2.28]), as well as the presence of relative > 18 years in the household (OR = 1.56 [95% CI: 1.0-2.43]), were associated with poor adherence to treatment. Conclusion: Sociocultural and behavioural factors are involved in acceptance of LTBI treatment in, immigrant children. Adherence to treatment is challenging and requires comperhension of sociocultural beliefs and accessibility to TB clinic. © 2010 King Saud Bin Abdulaziz University for Health Sciences.

Author Keywords

child Tuberculin skin test Patient acceptance of health care Patient compliance Emigration and immigration Mass screening Latent tuberculosis infection

Index Keywords

treatment response immigrant vomiting mass screening asthenia abdominal pain Prospective Studies human Schools Odds Ratio controlled study priority journal Eastern Europe family health school child Humans School Health Services liver toxicity Adolescent Antitubercular Agents male Canada latent tuberculosis female prediction Southeast Asia risk factor Risk Factors weight reduction side effect Article drug induced headache patient compliance major clinical study tuberculin test school health service migration isoniazid coughing Age Factors Emigration and Immigration Patient Acceptance of Health Care treatment refusal Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77953020810&doi=10.1016%2fj.jiph.2010.02.001&partnerID=40&md5=c8c78e74b262f8c2be5fbb6374dd32db
DOI: 10.1016/j.jiph.2010.02.001
ISSN: 18760341
Cited by: 23
Original Language: English