Tuberculosis: evidence review for newly arriving immigrants and refugees

Abstract

The casesOusman, a 32-year-old man; his 8-year-old daughter, Nene; and his 65-year-old mother, Mariama, from Casamance, Senegal, speak only Wolof and arrived in Canada six months ago from a refugee camp. What, if any, screening for latent tuberculosis should be done for this family?Active pulmonary tuberculosis was recently diagnosed in Harjit, a 65-year-old man who immigrated to Canada from India at age 32. Diabetes was diagnosed when he was 40 years old, and chronic renal failure developed one year ago that required dialysis because of the diabetes. Should screening for latent tuberculosis have been done for this man, and if so when?

Domestic impact of tuberculosis screening among new immigrants to Ontario, Canada

“…27,28 Among overseas applicants who are ineligible for, or choose not to receive, treatment, postimmigration surveillance can be limited to 1 year or less in most circumstances. Furthermore, postimmigration surveillance for domestic applicants (i.e., applicants who would have had a preimmigration medical in Canada in the previous year) is largely redundant and should be discontinued.…”

An unusual case of appendicitis

“…4 Our patient was under 11 years of age when applying for immigration and had his 11th birthday just before arrival in Canada. His mother confirmed that he did not have a pre-immigration chest radiograph, or any testing or treatment for TB in the past.…”

Hepatitis B virus screening and vaccination in a family from Nigeria

“…Testing for hepatitis B surface antibody (antiHBs) and hepatitis B core antibody (anti-HBc) should be done to screen for prior HBV immunity. 3,5 For the typical interpretation of serologic test results for HBV infection, see Table 2 in Appendix 5 of the evidence-based clinical guidelines for immigrants and refugees (available at www .cmaj.ca/content /183/12/E824 /suppl/DC1). …”

“…3 Identifying people with chronic hepatitis B through screening has several benefits: appropriately timed treatment can reduce the risk of endstage liver disease and hepatocellular carcinoma; 3 screening for hepatocellular carcinoma in certain groups at risk decreases associated mortality; 3 and transmission of hepatitis B virus (HBV) to nonimmune sexual and household contacts can be prevented through vaccination. …”