With the majority of active tuberculosis cases found in people arriving in Canada from six countries, a new study calls on Ottawa to improve its immigration health screening system.
Between 2008 and 2011, Citizenship and Immigration Canada screened out 157 prospective immigrants who were found to have active TB. 87.3 per cent came from Afghanistan, China, India, Pakistan, the Philippines and Vietnam. The study published in the Canadian Medical Association Journal, linked newcomer data from the immigration department and Ontario health ministry. It tracked the TB incidence rates among 944,375 immigrants settling here between 2002 and 2011.
According to Canadian laws all immigration applicants must undergo medical screening, including a medical history, physical examination, and a chest radiograph and testing for HIV, syphilis and chronic kidney disease. Those with suspected TB must go through further testing.
While individuals confirmed with active TB must complete treatment before being granted permanent residence status, those who only have a self-reported history or markers of old TB are referred to provincial health authorities for surveillance.
During the 10 years studied, 22,391 immigrants were referred by immigration officials to provincial health authorities for post-immigration surveillance, but only 13,387 followed the order. This left to only one in 40 cases actually being detected through post-immigration surveillance — an indication of the ineffectiveness of the post-immigration referral process, the study said.
Instead of focusing risk assessment based on chest X-rays, officials should also take into account immigrants’ birth country and the status of their immune systems.