Peter Warrington1, Gregory Tyrrell2,3, Kimberley Choy4, Lisa Eisenbeis5, Richard Long1,6, Ryan Cooper7. 1. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. 2. Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada. 3. Provincial Laboratory for Public Health, Alberta Health Services, Edmonton, AB, Canada. 4. Public Health, Alberta Health Services, Edmonton, AB, Canada. 5. Edmonton Tuberculosis Clinic, Alberta Health Services, Edmonton, AB, Canada. 6. School of Public Health, University of Alberta, Edmonton, AB, Canada. 7. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. rdcooper@ualberta.ca.
Abstract
OBJECTIVES: Canada has accepted more than 25,000 Syrian refugees fearing persecution in their homeland. Canadian guidelines recommend screening recent refugees from high incidence countries for tuberculosis (TB) and latent TB infection (LTBI). The prevalence of TB in this population is unknown. A refugee clinic in Edmonton presented a unique opportunity to estimate prevalence of TB and LTBI in Syrian refugees arriving in Canada. METHODS: In January 2016, 100 consecutive Syrian refugees were screened for TB with clinical assessment and LTBI using QuantiFERON Gold In-Tube assay (QFT-GIT). Patients with positive QFT-GIT were referred to Edmonton Tuberculosis Clinic (ETBC) for evaluation and, if appropriate, offered prophylaxis. RESULTS: No cases of active TB were found. Valid QFT-GIT were measured in 99 of 100 individuals and of these, nine (9%) were positive using a threshold concentration of blood interferon-γ greater than 0.35 IU/L. Eight of the nine patients attended follow-up appointments; of these, seven began LTBI prophylaxis and all seven (78%) completed same. CONCLUSION: The 9% (95% confidence interval 3-15%) prevalence of LTBI was higher than expected in this population.
OBJECTIVES: Canada has accepted more than 25,000 Syrian refugees fearing persecution in their homeland. Canadian guidelines recommend screening recent refugees from high incidence countries for tuberculosis (TB) and latent TB infection (LTBI). The prevalence of TB in this population is unknown. A refugee clinic in Edmonton presented a unique opportunity to estimate prevalence of TB and LTBI in Syrian refugees arriving in Canada. METHODS: In January 2016, 100 consecutive Syrian refugees were screened for TB with clinical assessment and LTBI using QuantiFERON Gold In-Tube assay (QFT-GIT). Patients with positive QFT-GIT were referred to Edmonton Tuberculosis Clinic (ETBC) for evaluation and, if appropriate, offered prophylaxis. RESULTS: No cases of active TB were found. Valid QFT-GIT were measured in 99 of 100 individuals and of these, nine (9%) were positive using a threshold concentration of blood interferon-γ greater than 0.35 IU/L. Eight of the nine patients attended follow-up appointments; of these, seven began LTBI prophylaxis and all seven (78%) completed same. CONCLUSION: The 9% (95% confidence interval 3-15%) prevalence of LTBI was higher than expected in this population.
Authors: F Naufal; L H Chaisson; K O Robsky; P Delgado-Barroso; H S Alvarez-Manzo; C R Miller; A E Shapiro; J E Golub Journal: Int J Tuberc Lung Dis Date: 2022-06-01 Impact factor: 3.427