Post-migration screening for active tuberculosis in Victoria, Australia

Flynn, Michael G.; Brown, Lawrason; Tesfai, Afewerki Weldezgi; Lauer, Therese

doi:10.5588/ijtld.10.0565

Cited by 13 publications

(7 citation statements)

References 9 publications

(9 reference statements)

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“…Alvarez et al surveyed screening practices in high migration, low incident countries in 2008 and found that on-entry screening was undertaken by Norway, Switzerland and the UK (out of a total of 13) and often aimed at migrant sub-populations -for example limiting screening to migrants from countries with higher estimated TB incidence, or to high risk populations, such as refugees or asylum seekers (16). Some countries utilise post-arrival screening programmes, for example as a required component of access to specific services, in holding centres (26) or as follow up to pre-entry screening (27), and these are often limited to specific high risk target populations or settings (17). Pre-entry screening programmes are now used by a number of countries.…”

Section: Effectiveness Of Active Tb Screeningmentioning

confidence: 99%

Effectiveness and cost-effectiveness of screening migrants for active tuberculosis and latent tuberculous infection

Zenner

Hafezi

Potter

et al. 2017

int j tuberc lung dis

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With the advent of the World Health Organization End TB strategy, there has been renewed interest in screening for active tuberculosis (TB), and particularly latent tuberculous infection (LTBI). In low-incidence countries, a high proportion of TB cases are notified among migrants, which often occurs due to LTBI reactivation. We aimed to review the effectiveness and cost-effectiveness of screening migrants for active TB LTBI to inform and support the TB elimination strategy in low-incidence countries. We carried out a narrative review of English language articles published between 1 January 2000 and 31 June 2016 using the PubMed database. All studies that described the effectiveness or cost-effectiveness of active TB or LTBI screening among migrants were included. We identified 55 studies, and included 40 for the effectiveness of screening, 11 for cost-effectiveness and 4 that reported both. Screening for active TB can be effective and cost-effective depending on the setting, target group and screening approach. Pre-entry screening programmes have some impact on the epidemiology of the receiving countries. The effectiveness and cost-effectiveness of LTBI screening as predicted in mathematical models is also highly setting-specific, with best potential results achieved if screening is restricted to high-risk groups and/or to migrants from high-burden countries.

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Section: Effectiveness Of Active Tb Screeningmentioning

confidence: 99%

Effectiveness and cost-effectiveness of screening migrants for active tuberculosis and latent tuberculous infection

Zenner

Hafezi

Potter

et al. 2017

int j tuberc lung dis

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“…Linkage of records across databases has become an important tool for combining records that belong to the same entity across different data sources [ 8 , 9 , 16 – 20 ]. This activity consists of matching records in one database to records in another database, often a population registry, and creating a unique encoded identifier that is identical across the databases (henceforth called “record linkage”).…”

Section: Introductionmentioning

confidence: 99%

Describing the linkages of the immigration, refugees and citizenship Canada permanent resident data and vital statistics death registry to Ontario’s administrative health database

Chiu

Lebenbaum

Lam

et al. 2016

BMC Med Inform Decis Mak

157

160

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BackgroundOntario, the most populous province in Canada, has a universal healthcare system that routinely collects health administrative data on its 13 million legal residents that is used for health research. Record linkage has become a vital tool for this research by enriching this data with the Immigration, Refugees and Citizenship Canada Permanent Resident (IRCC-PR) database and the Office of the Registrar General’s Vital Statistics-Death (ORG-VSD) registry. Our objectives were to estimate linkage rates and compare characteristics of individuals in the linked versus unlinked files.MethodsWe used both deterministic and probabilistic linkage methods to link the IRCC-PR database (1985–2012) and ORG-VSD registry (1990–2012) to the Ontario’s Registered Persons Database. Linkage rates were estimated and standardized differences were used to assess differences in socio-demographic and other characteristics between the linked and unlinked records.ResultsThe overall linkage rates for the IRCC-PR database and ORG-VSD registry were 86.4 and 96.2 %, respectively. The majority (68.2 %) of the record linkages in IRCC-PR were achieved after three deterministic passes, 18.2 % were linked probabilistically, and 13.6 % were unlinked. Similarly the majority (79.8 %) of the record linkages in the ORG-VSD were linked using deterministic record linkage, 16.3 % were linked after probabilistic and manual review, and 3.9 % were unlinked. Unlinked and linked files were similar for most characteristics, such as age and marital status for IRCC-PR and sex and most causes of death for ORG-VSD. However, lower linkage rates were observed among people born in East Asia (78 %) in the IRCC-PR database and certain causes of death in the ORG-VSD registry, namely perinatal conditions (61.3 %) and congenital anomalies (81.3 %).ConclusionsThe linkages of immigration and vital statistics data to existing population-based healthcare data in Ontario, Canada will enable many novel cross-sectional and longitudinal studies to be conducted. Analytic techniques to account for sub-optimal linkage rates may be required in studies of certain ethnic groups or certain causes of death among children and infants.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0375-3) contains supplementary material, which is available to authorized users.

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“…19 Such approaches have been demonstrated to be effective for active tuberculosis, however they would need to be developed and assessed for effectiveness in relation to the particular needs of LTBI management. 20 Screening policy may be applied to all immigrants, or could be limited to a subset (for instance, those from countries with a higher prevalence of tuberculosis infection, or those considered at higher personal risk, such as refugees and asylum seekers or immigrants with HIV infection). 21 Any such limitation in the scope of screening policy would need to be justified on clear objective grounds to ensure that arbitrary discrimination did not occur.…”

Section: Circumstances Of Screeningmentioning

confidence: 99%

Ethical evaluation of immigration screening policy for latent tuberculosis infection

Denholm

McBryde

Brown

2012

Australian and New Zealand Journal of Public Health

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Key words: ethics, latent tuberculosis, immigration, public health, interferongamma release assays, tuberculin test Aust NZ J Public Health. 2012; 36:325-8 doi: 10.1111/j.1753-6405.2012 could operate in a variety of ways, which would aim to detect LTBI in immigrants to Australia or NZ and provide treatment to prevent later disease.In addition to any logistic considerations, such policies raise a number of ethical implications that require careful analysis prior to implementation. The focus of this article is to review the potential alternatives for the introduction of LTBI screening into Australasian immigration policy, with a particular emphasis on the ethical evaluation of various strategies. MethodsCurrent Australian and NZ immigration policies related to tuberculosis were reviewed. Relevant Federal Government department websites and publications were accessed to summarise immigration screening approaches to tuberculosis infection.Introduction of screening and treatment for LTBI could be incorporated into new public health policy with a variety of permutations. Key elements of such changes were extracted and described in order to allow ethical evaluation of various permutations in policy development. Denholm, McBryde and Brown ArticleA number of frameworks have been proposed for the ethical evaluation of public health policy, including immigration screening. Some approaches have emphasised national sovereignty, with its rights (or even obligations) to exercise immigration control on behalf of its citizens. 8 Other approaches have rejected national interests in favour of more universal considerations. Particularly influential in this regard have been approaches based on human rights considerations, such as the models adapted for assessment of mandatory HIV screening.9,10 Such approaches emphasise limiting the burdens of screening on immigrants, particularly through appropriate targeting and adopting the least restrictive alternatives which achieve the desired public health benefit.While a number of frameworks could be applied to the evaluation of public health policy, few have been developed specifically with this context in mind. One exception is the principle-based analytic approach proposed by Nancy Kass.11 This approach seeks to take into account the dynamic tension between harms and benefits to individuals and societies, and encourages systematic evaluation of public health policy on ethical grounds. The central concepts within this framework are the design of public health policy which minimises burdens and maximises benefits, and the fair allocation of those burdens and benefits. This present analysis adopts these principles in order to consider the ethical implications of potential public health policy changes in relation to immigration screening for LTBI. Results Existing Australasian immigration policiesCurrently, most applicants for immigration to Australia or NZ are required to undergo an assessment for active tuberculosis. 12,13 Requirements for both countries are similar, primarily consisti...

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Post-migration screening for active tuberculosis in Victoria, Australia

Abstract: Selective post-migration screening can achieve a high yield of notified TB.

Cited by 13 publications

References 9 publications

Effectiveness and cost-effectiveness of screening migrants for active tuberculosis and latent tuberculous infection

Effectiveness and cost-effectiveness of screening migrants for active tuberculosis and latent tuberculous infection

Describing the linkages of the immigration, refugees and citizenship Canada permanent resident data and vital statistics death registry to Ontario’s administrative health database

Ethical evaluation of immigration screening policy for latent tuberculosis infection

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