在新不伦瑞克省南部移民中加强肺结核感染筛查:一项横断面试点研究。

Isdore Chola Shamputa, Duyen Thi Kim Nguyen, Hope Mackenzie, Derek J Gaudet, Alicia Harquail, Kim Barker, Duncan Webster
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摘要

背景:2021年,加拿大大约77%的活动性结核病(TBD)病例是在外国出生的人。在加拿大,不到3%的TBD病例是通过抵达加拿大移民前的医学检查(即胸部x光片)发现的,其余97%可能是由于抵达后未确诊的潜伏性结核感染(TBI)重新激活。在新不伦瑞克省,外国出生个体的TBD病例比例从2013年的约33%(1/3个体)逐渐增加到2023年的100%(14/14个体)。本研究的目的是估计新不伦瑞克省南部移民中TBI的患病率,确定TBI阳性筛查的潜在预测因素,并评估参与者对TBI试点筛查程序的体验。方法:在2021年11月至2023年11月期间,对年龄≥19岁、无TBD病史、出生在结核病发病率≥40/10万人口的国家或由卫生保健专业人员转诊的移民进行横断面研究。参与者通过各种渠道招募,并使用干扰素- γ释放法进行TBI筛查,随后对他们的筛查经验进行调查。结果:264名参与者中,49名(18.6%)筛查为TBI阳性。与tbi阳性筛查几率较高相关的因素包括:出生在“高度至严重流行”(≥300/100,000人口)结核病发病率国家(OR=3.24; 95% CI: 1.07-9.81)和年龄增加(OR=1.05; 95% CI: 1.01-1.08)。参与者对试点TBI筛查程序的评价是积极的(5分李克特量表的平均得分范围为4.03-4.55)。结论:结果提示出生在结核病发病率≥300/10万人口的国家的移民应考虑筛查和治疗TBI。试点TBI筛选程序产生了积极的反馈。建议进行更大样本的进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Enhanced screening for tuberculosis infection among immigrants in southern New Brunswick: A cross-sectional pilot study.

Enhanced screening for tuberculosis infection among immigrants in southern New Brunswick: A cross-sectional pilot study.

Background: In 2021, approximately 77% of active tuberculosis (TB) disease (TBD) cases in Canada were among foreign-born individuals. Less than 3% of TBD cases in Canada are detected through pre-arrival Canadian immigration medical examinations (i.e., chest X-rays), and the remaining 97% are likely due to reactivation of undiagnosed latent TB infection (TBI) post-arrival. In New Brunswick, the proportion of TBD cases among foreign-born individuals gradually increased from about 33% (1/3 individuals) in 2013 to 100% (14/14 individuals) in 2023. The objective of this study was to estimate the prevalence of TBI among immigrants in southern New Brunswick, identify potential predictors for positive TBI screening and assess participant experiences with the pilot TBI screening procedure.

Methods: A cross-sectional study was conducted from November 2021 to November 2023 among immigrants ≥19 years old who had no history of TBD and were born in a country with a TB incidence rate of ≥40/100,000 population or were referred by healthcare professionals. Participants were recruited through various channels and underwent TBI screening using the interferon-gamma release assay, followed by a survey on their screening experience.

Results: Of the 264 participants, 49 (18.6%) screened positive for TBI. Factors associated with higher odds of screening TBI-positive included birthplace in a "highly to severely endemic" (≥300/100,000 population) TB-incidence country (OR=3.24; 95% CI: 1.07-9.81) and increased age (OR=1.05; 95% CI: 1.01-1.08). Participants rated the pilot TBI screening procedure positively (mean scores ranged from 4.03-4.55 on a five-point Likert scale).

Conclusion: Results suggest that immigrants born in countries with TB incidences of ≥300/100,000 population should be considered for screening and treatment of TBI. The pilot TBI screening procedure yielded positive feedback. Further research with a larger sample is recommended.

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