Immigrant Arrival and Tuberculosis among Large Immigrant- and Refugee-Receiving Countries, 2005–2009

Abstract

Objective. Tuberculosis control in foreign-born populations is a major public health concern for Australia, Canada, New Zealand, United Kingdom, and the United States, large immigrant- and refugee-receiving countries that comprise the Immigration and Refugee Health Working Group (IRHWG). Identifying and comparing immigration and distribution of foreign-born tuberculosis cases are important for developing targeted and collaborative interventions. Methods. Data stratified by year and country of birth from 2005 to 2009 were received from these five countries. Immigration totals, tuberculosis case totals, and multidrug-resistant tuberculosis (MDR TB) case totals from source countries were analyzed and compared to reveal similarities and differences for each member of the group. Results. Between 2005 and 2009, there were a combined 31,785,002 arrivals, 77,905 tuberculosis cases, and 888 MDR TB cases notified at the federal level in the IRHWG countries. India, China, Vietnam, and the Philippines accounted for 41.4% of the total foreign-born tuberculosis cases and 42.7% of the foreign-born MDR tuberculosis cases to IRHWG. Interpretation. Collaborative efforts across a small number of countries have the potential to yield sizeable gains in tuberculosis control for these large immigrant- and refugee-receiving countries.

Lineage specific histories of Mycobacterium tuberculosis dispersal in Africa and Eurasia

“…Isolates were assembled via reference‐guided assembly (RGA) when FASTQ data were available and by multiple genome alignment (MGA) when only draft genome assemblies were accessible (see Sections 2.3 and 2.4). As we were interested in reconstructing historical migrations of the pathogen, we excluded countries where the majority of contemporary TB cases are identified in recent immigrants (Australian Government Department of Health & Ageing, ; Centers for Disease Control, ; Government of Canada, ; Institute of Environmental Science & Research Limited, ; Public Health England, ; White et al, ). Due to computational limitations (BEAST analyses), we necessarily took measures to limit our data set to <600 isolates.…”

Capacity strengthening through pre-migration tuberculosis screening programmes: IRHWG experiences

“…This analysis helps demonstrate that, because the number of panel physician is large in many high-TB-incidence source countries, IRHWG countries are uniquely positioned to have their investments in screening programmes also contribute to local prevention and treatment efforts through development of relationships with TB controllers, sharing laboratory capacity, and comanaging TB cases where DOT capacity is scarce. 11 This means that a strategy to develop infrastructure in IRHWG screening programmes also has the potential to have an impact domestically for each IRHWG country, as well as contribute to global TB efforts. 26 Because many of these examples are in countries with both a high TB incidence and low levels of TB infrastructure, as we have demonstrated, this collaborative effort has catalysed laboratory and treatment infrastructure or training and education activities that may not have otherwise been possible.…”

“…31 Addressing the pre-migration phase, TB screening programmes from Australia, Canada, NZ, USA, and the UK consistently show the effectiveness of early diagnosis and TB management in migrants. 20,[39][40][41][42] These collaborative efforts have the potential to yield sizeable gains in TB mitigation for migrant-and refugee-receiving countries 11 and, through the capacity and linkages developed overseas, also provide sizeable contributions to source country TB programs.…”

“…41 The long-term goal in decreasing migration-related introduction of TB from high-to lowincidence countries means diminishing the prevalence of the disease in those high-incidence source locations. 11 As argued, overseas TB screening programmes for migration and refugee resettlement contribute to this through development of laboratory and treatment capacity.…”

Intergovernmental collaboration for the health and wellbeing of refugees settling in Australia

“…14 The inclusion of a skin condition assessment, and treatment for scabies and lice, is a recent PMHS policy change for Australiabound refugees. This was influenced by the practices of other IRHWG countries and by evidence of a high prevalence of untreated skin conditions leading to ill health in Syrian refugees in Jordan.…”