Treating TB from beyond Canada's border

October 02, 2000

Many immigrants arriving in Canada from developing countries are known to be at risk for tuberculosis. Dr. Wendy Wobeser and colleagues have analyzed data from the Ontario Reportable Disease Information Service and the Citizenship and Information database to identify higher risk groups within this population.

A total of 1341 cases of tuberculosis in foreign-born people were reported in Ontario in 1994-1995 and of that number, 602 were eligible for inclusion in the study. The authors report that the 2 strongest determinants of risk are referral for medical surveillance by immigration officials and region of origin. Immigrants from Vietnam had the highest incidence of tuberculosis, and accounted for 107 (17.8%) of all the 602 cases.

The authors support current recommendations for focusing preventive strategies on people referred to local health authorities by immigration officials, but warn that opportunities to prevent future cases of tuberculosis may be lost.

"The current system has a number of shortcomings, including the lack of notification of the appropriate Canadian public health authorities, poor adherence to the guidelines for medical surveillance in Canada, and low rates of preventive therapy among those referred for surveillance," state the authors.

The study is considered important because the responsibility for understanding the health care needs of migrants lies with the host country. Removing barriers to the care of the migrants will be key in protecting the Canadian-born population.
Expanding the epidemiologic profile: risk factors for active tuberculosis in people immigrating to Ontario -- W.L. Wobeser et al.

Contact: Dr. Wendy Wobeser, Queen's University, Kingston, Ontario

Canadian Medical Association Journal

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