Predictors of postimmigration active tuberculosis at any site among permanent residents 11 years of age and older, 2002–2011
| Predictor | HR (95% CI) |
|---|---|
| Postimmigration surveillance referral* | |
| Not referred | 1.00 |
| Referred, baseline hazard | 4.68 (3.76–5.82) |
| Referred, additional hazard during first year of immigration | 5.69 (4.16–7.79) |
| Tuberculosis incidence in country of birth† | |
| 0–30 (reference) | 1.00 |
| > 30–100 | 3.72 (2.29–6.06) |
| > 100–200 | 6.27 (3.90–10.07) |
| > 200 | 13.65 (8.64–21.57) |
| Immigration category‡ | |
| Live-in caregiver | 4.15 (3.51–4.90) |
| Refugee | 2.46 (1.87–3.25) |
| Other (reference) | 1.00 |
| Age at immigration, yr§ | |
| 11–35 | 1.30 (1.13–1.50) |
| > 35–65 (reference) | 1.00 |
| > 65 | 1.36 (1.05–1.74) |
| Application for residency in Canada¶ | 0.39 (0.32–0.47) |
| Immunocompromised** | 1.75 (1.30–2.36) |
Nopte: CI = confidence interval, HR = hazard ratio.
↵* People who did not have evidence of active pulmonary tuberculosis on preimmigration medical exmination but who had markers of old tuberculosis on chest radiography, or who had a self-reported history of active tuberculosis, and were consequently referred by federal immigration officials to the Ontario Ministry of Health and Long-Term Care. Reference group represents those not referred for postimmigration surveillance.
↵† Average World Health Organization tuberculosis incidence rate (all sites) in immigrants’ birth country during the 3-year period before immigration.
↵‡ Live-in Caregivers were classified by Citizenship and Immigration Canada as either as the principal applicant (20 793) or their spouse or dependent (16 024). Refugees were classified as “Refugees landed in Canada” (81 345), “Humanitarian and Compassionate cases” (49 364), “Government-assisted refugees” (24 807), “Refugee dependents” (29 919), “Privately-sponsored refugees” (19 139), and other miscellaneous categories (216).
↵§ Children under age 11 were excluded from this analysis since chest radiographs are not routinely performed as part of their immigration medical exam.
↵¶ Reference group represents individuals who applied for permanent residency from overseas.
↵** Immunocompromised states included diabetes mellitus (15 424; 79.7%), chronic renal failure (3027; 15.7%) and HIV infection (890; 4.6%) at the time of immigration. Reference group represents patients without reported immunocompromise.