Late Breaking Abstract - Predictors of tuberculosis among immigrants referred for post-landing surveillance in British Columbia, Canada

Le résumé fourni par la source

Background: Tuberculosis (TB) disproportionately affects immigrant populations in Canada. While The Immigration Medical Examinations (IMEs) prior to entry to Canada helps identify people at high TB risk, the predictive value of the IME for post-arrival TB disease remains unclear. Objective: We aimed to assess the association between clinical and demographic predictors recorded during the IME and the risk of developing TB disease within two years of arrival among people referred for post-landing surveillance in British Columbia (BC), Canada. Methods: We conducted a population-based, retrospective cohort study of 2,896 people referred for post-landing surveillance between 2020 and 2022. Using Cox proportional hazards models, we evaluated associations between baseline IME variables, such as chest x-ray findings, prior TB treatment, and country-level TB incidence, and time to TB disease diagnosis. Individuals were followed for two years, with TB diagnoses confirmed through BC’s provincial TB registry. Results: Among 2,896 participants, 31 (1.1%) developed TB disease within two years post-arrival. Abnormal chest x-ray was the strongest predictor: 97% of diagnosed individuals had abnormal imaging at IME. The TB incidence rate among those with abnormal chest x-rays was 656 per 100,000 person-years, compared to 85 per 100,000 for those with normal radiographs. In multivariable Cox regression, abnormal x-ray findings were significantly associated with higher TB risk (HR:2.14;95% CI:1.20-3.82;p=0.01). Conclusion: Abnormal chest x-ray findings during the IME help predict progression to TB disease within two years of arrival. Prioritizing post-landing follow-up may improve early detection.

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