Piecing the puzzle together: foreign-born tuberculosis in an immigrant-receiving country
Piecing the puzzle together: foreign-born tuberculosis in an immigrant-receiving country
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DOI：
10.1183/09031936.00196610
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发表时间：
2011-10-01
影响因子：
24.3
通讯作者：
Long, R.
中科院分区：
文献类型：
--
作者：
Langlois-Klassen, D.;Wooldrage, K. M.;Long, R.
在接受移民的主要国家，每年外国出生的结核病(TB)病例数量和比率相对稳定。为什么会这样，以及谁可能是筛查潜在结核病感染的高收益目标，仍然是悬而未决的问题。1986年至2002年期间，加拿大的外国出生结核病被回顾调查，使用的是国家结核病和移民数据以及人口普查数据。1986年以前的移民(n=3,860,853)和1986-2002年的移民(n=3,463,283)分别贡献了8,662例和9,613例结核病病例。10年前抵达的移民对每年外国出生的结核病病例数量的贡献几乎相同，尽管在国内的人年差异是3.5倍。在移民10年后观察到显著稳定和相对较低的结核病发病率。相反，抵达后5年内的结核病发病率是动态的，表现出与抵达后的时间呈强烈的负相关，而且对移民水平的变化比向更高发病率来源国家的转移更敏感。外国出生的结核病发病率的相对稳定性是由几个因素的复杂趋同来解释的。出生在高发国家的移民
In major immigrant-receiving countries, annual foreign-born tuberculosis (TB) case counts and rates are relatively constant. Why this is so, and who might be a high-yield target for screening for latent TB infection, remain open questions.Foreign-born TB in Canada during 1986-2002 was retrospectively examined using national TB and immigration data as well as census data. Case counts and rates were analysed in relation to demographics, immigration period and time since arrival.Pre-1986 immigrants (n=3,860,853) and 1986-2002 immigrants (n=3,463,283) contributed 8,662 and 9,613 TB cases, respectively. Immigrants arriving 10 yrs ago contributed almost equally to the annual foreign-born TB case count despite a 3.5-fold difference in in-country person-yrs. Remarkably stable and relatively low TB incidence was observed among immigrants >10 yrs post-arrival. Conversely, TB incidence within 5 yrs of arrival was dynamic, demonstrating a strong inverse association with time since arrival and higher sensitivity to changes in immigration level than shifts toward higher incidence source countries.Relative constancy in foreign-born TB incidence is explained by a complex convergence of several factors. Immigrants born in high-incidence countries who arrived