Acceptance of screening and completion of treatment for latent tuberculosis infection among refugee claimants in Canada
Abstract:SETTING: Primary care clinic for refugee claimants, Montreal, Canada.
OBJECTIVES: To identify factors linked to the acceptance of the tuberculin skin test (TST), and assess completion of treatment for latent tuberculosis infection (LTBI).
DESIGN: Asylum seekers consulting for a medical complaint or medical immigration examination between February and October 1999 were assessed for eligibility. Personal and clinical information was gathered prospectively by questionnaire. Hospital files were reviewed to assess completion of LTBI treatment.
RESULTS: In our study, 296 subjects (72.4% of 409 eligible) were offered TST, of whom 227 accepted (76.7%). Of these, 49 (24.9%) had a TST ≥10 mm and 24 (49%) completed 6 months of LTBI treatment. Logistic regression models showed that patients who had never had a TST (OR 3.2, 95%CI 1.34–7.6) or had no temporary exclusion criteria (OR 4.0, 95%CI 1.6–9.9) were more likely to accept TST. Perceiving tuberculosis as a severe disease (OR 0.29, 95%CI 0.09–0.91) and consulting for an immigration examination (OR 0.42, 95%CI 0.18–0.98) was associated with refusal of TST. Increasing age was found to be independently associated with a positive TST (OR 1.06, 95%CI 1.01–1.12). Variability in the proportion of positive results was found between TST readers.
CONCLUSION: This study supports the feasibility of screening refugee claimants for LTBI during medical consultation and of developing organizational links to ensure completion of LTBI treatment.
Document Type: Regular Paper
Affiliations: 1: Direction des systèmes de soins et services, Institut national de santé publique du Québec, Montreal, Quebec, Canada; Direction de Santé Publique de Montréal-Centre, Montreal, Quebec, Canada; and the Département de Médecine sociale et préventive, Université de Montréal, Montreal, Quebec, Canada 2: CLSC Côte-des-Neiges, Clinique Santé-Accueil, Montreal, Quebec, Canada 3: Direction de Santé Publique de Montréal-Centre, Montreal, Quebec, Canada; Département de Médecine sociale et préventive, Université de Montréal, Montreal, Quebec, Canada; and the Department of Epidemiology, Biostatstics and Occupational Health, McGill University, Montreal, Quebec, Canada
Publication date: June 1, 2004
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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