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Clinical, Laboratory and Treatment Outcome Characteristics of Foreign-Born Pulmonary Tuberculosis Patients in Alberta by Immigration Status, 2004-2013

  • Author / Creator
    Quach, Kimberly
  • Canada is a low TB incidence country, with a rate of 4.4 per 100,000 in 2014. Despite this low incidence rate, TB affects certain groups disproportionately, most notably foreign-born persons from high incidence countries and Indigenous peoples. This study compares clinical, laboratory, and treatment outcome characteristics of two groups of foreign-born pulmonary (PTB) patients in Alberta: Canadian citizens/permanent residents and temporary residents/refugees. A retrospective cohort analysis was conducted on culture-positive PTB patients classified as foreign-born and diagnosed in Alberta between 2004 and 2013. Univariate and multiple logistic regression analyses were performed to determine whether there are predictors of advanced disease and poor treatment outcomes based on clinical and laboratory characteristics and immigration status. Results showed some differences between Canadian citizens/permanent residents and temporary residents/refugees. Of the 1200 foreign-born TB cases, 80.0% were Canadian citizens/permanent residents and 20.0% were temporary residents/refugees. More temporary residents/refugees (38.0%) were identified through an Immigration, Refugees and Citizenship Canada (IRCC) referral than Canadian citizens/permanent residents (8.7%). Patients who were identified through an IRCC referral were less likely to have advanced disease (OR 0.04, p<0.001). Older age, positive HIV status, and advanced disease were associated with unsatisfactory treatment outcomes. Current IRCC screening and surveillance practices are missing a significant number of individuals who later go on to develop active TB. Review of these screening practices, with more attention given to preventative therapy, must be considered in low-incidence immigrant-receiving countries such as Canada.

  • Subjects / Keywords
  • Graduation date
    2017-11:Fall 2017
  • Type of Item
    Thesis
  • Degree
    Master of Science
  • DOI
    https://doi.org/10.7939/R3251G03T
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
    English
  • Institution
    University of Alberta
  • Degree level
    Master's
  • Department
    • School of Public Health
  • Specialization
    • Global Health
  • Supervisor / co-supervisor and their department(s)
    • Saunders, Duncan (School of Public Health)
    • Long, Richard (Department of Medicine)
  • Examining committee members and their departments
    • Voaklander, Don (School of Public Health)
    • Saunders, Duncan (School of Public Health)
    • Jhangri, Gian (School of Public Health)
    • Long, Richard (Department of Medicine)