Background
Methods
Study population and participant recruitment
Study design
Study measurements
Main statistical analyses
Sensitivity analyses
Results
Study sample
Participant characteristics
Characteristics
|
Treated for tuberculosis disease
|
Treated for latent tuberculosis infection
|
Screened for tuberculosis but healthy and untreated
| ||||||
---|---|---|---|---|---|---|---|---|---|
Total (%)
|
Men (%)
|
Women (%)
|
Total (%)
|
Men (%)
|
Women (%)
|
Total (%)
|
Men (%)
|
Women (%)
| |
Sample size | 48 (18) | 27 (56) | 21 (44) | 105 (40) | 45 (43) | 60 (57) | 110 (42) | 50 (45) | 60 (55) |
Mean (standard deviation) age - years | 37 (12) | 38 (15) | 36 (7) | 33 (9) | 34 (9) | 33 (10) | 35 (8) | 34 (8) | 35 (8) |
Region of origin | |||||||||
Africa | 15 (31) | 12 (44) | 3 (13) | 29 (28) | 18 (40) | 11 (19) | 34 (31) | 16 (32) | 18 (30) |
Asia | 18 (38) | 8 (29) | 10 (47) | 28 (27) | 8 (18) | 20 (33) | 21 (19) | 11 (22) | 10 (17) |
Eastern Europe | 3 (6) | 1 (4) | 2 (10) | 5 (5) | 3 (7) | 2 (3) | 12 (11) | 5 (10) | 7 (12) |
Western Europe | 1 (2) | 1 (4) | 0 (0) | 5 (5) | 3 (7) | 2 (3) | 10 (9) | 5 (10) | 5 (8) |
Central America | 3 (6) | 1 (4) | 2 (10) | 20 (18) | 6 (13) | 14 (24) | 18 (16) | 7 (14) | 11 (18) |
North America | 5 (11) | 3 (11) | 2 (10) | 11 (10) | 5 (11) | 6 (10) | 11 (10) | 4 (8) | 7 (12) |
South America | 3 (6) | 1 (4) | 2 (10) | 7 (7) | 2 (4) | 5 (8) | 4 (4) | 2 (4) | 2 (3) |
Median (inter-quartile range) duration in Canada (years) | 2 (0–7) | 2 (0–10) | 2 (0–7) | 3 (1–9) | 1 (0–6) | 5 (2–10) | 2 (1–9) | 2 (1–7) | 2 (1–9) |
Reason for hospital referral | |||||||||
Pre-landing refugee or immigrant screening | 9 (19) | 5 (19) | 4 (19) | 6 (6) | 3 (7) | 3 (5) | 17 (15) | 10 (20) | 7 (12) |
Post-landing surveillance | 7 (15) | 3 (11) | 4 (19) | 11 (10) | 7 (16) | 4 (7) | 7 (6) | 4 (8) | 3 (5) |
Tuberculin Skin Test, not contact of patient with diagnosed TB disease | 1 (2) | 0 (0) | 1 (5) | 64 (61) | 22 (49) | 42 (70) | 67 (61) | 27 (54) | 40 (67) |
Contact of patient with diagnosed TB disease | 1 (2) | 0 (0) | 1 (5) | 18 (17) | 10 (22) | 8 (13) | 5 (5) | 3 (6) | 2 (3) |
Symptomatic of TB disease‡
| 24 (50) | 17 (63) | 7 (33) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Other | 6 (13) | 2 (7) | 4 (19) | 6 (6) | 3 (7) | 3 (5) | 0 (0) | 0 (0) | 0 (0) |
Unknown | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 14 (13) | 6 (12) | 8 (13) |
Smoking status | |||||||||
Ever cigarette smoker* | 18 (38) | 14 (52) | 4 (19) | 24 (23) | 15 (33) | 9 (15) | 23 (21) | 14 (28) | 9 (15) |
Current cigarette smoker†
| 11 (23) | 9 (33) | 2 (10) | 8 (8) | 5 (11) | 3 (5) | 10 (9) | 5 (10) | 5 (8) |
Median (inter-quartile range) pack-years smoking | 13 (6–19) | 17 (8–20) | 5 (3–9) | 4 (1–16) | 2 (1–16) | 5 (2–12) | 6 (3–18) | 5 (1–18) | 6 (4–21) |
Findings from univariable analyses
Participants
|
Treated for tuberculosis disease
|
Treated for latent tuberculosis infection
|
Screened for tuberculosis but healthy and untreated
| ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
VISIT
|
BY SEX
|
N (%)
|
Mean score (Standard Deviation)
|
Effect size
1
a
|
Effect size
2
b
|
N (%)
|
Mean score (Standard Deviation)
|
Effect size
1
a
|
Effect size
2
b
|
N (%)
|
Mean score (Standard Deviation)
|
Effect size
1
a
|
Effect size
2
b
|
Baseline | Total | 33 | 49.5 (1.3) | - | - | 81 | 50.3 (1.1) | - | - | 91 | 50.2 (0.7) | - | - |
Men | 19 (58) | 49.6 (1.5) | - | - | 37 (46) | 50.2 (0.9) | - | - | 41 (45) | 50.1 (0.6) | - | - | |
Women | 14 (42) | 49.4 (1.2) | - | - | 44 (54) | 50.4 (1.2) | - | - | 50 (55) | 50.3 (0.8) | - | - | |
1 month | Total | 36 | 49.5 (1.0) | 0.0 | - | 58 | 50.2 (0.9) | −0.1 | - | 75 | 50.2 (0.8) | 0.0 | - |
Men | 21 (58) | 49.6 (1.1) | 0.0 | - | 22 (38) | 50.2 (0.6) | 0.1 | - | 38 (51) | 50.2 (0.9) | 0.2 | - | |
Women | 15 (42) | 49.4 (0.8) | 0.0 | - | 36 (62) | 50.2 (1.1) | −0.1 | - | 37 (49) | 50.1 (0.8) | −0.2 | - | |
2 months | Total | 39 | 49.5 (1.0) | 0.0 | 0.0 | 52 | 50.3 (0.8) | 0.0 | 0.1 | 77 | 50.1 (0.8) | −0.1 | 0.0 |
Men | 23 (59) | 49.7 (1.2) | 0.1 | 0.1 | 23 (44) | 50.2 (0.8) | 0.0 | 0.0 | 37 (48) | 50.1 (0.8) | 0.1 | 0.0 | |
Women | 16 (41) | 49.2 (0.5) | −0.2 | −0.2 | 29 (56) | 50.3 (0.8) | 0.0 | 0.1 | 40 (52) | 50.1 (0.8) | −0.2 | 0.0 | |
4 months | Total | 32 | 50.1 (1.2) |
0.5
|
0.5
| 53 | 50.1 (0.8) | −0.2 | −0.2 | 56 | 50.1 (0.7) | −0.1 | 0.0 |
Men | 19 (59) | 50.4 (1.4) |
0.6
|
0.5
| 26 (49) | 50.0 (0.7) | −0.2 | −0.2 | 24 (75) | 50.2 (0.6) | 0.1 | 0.0 | |
Women | 13 (41) | 49.6 (0.4) | 0.3 |
0.8
| 27 (51) | 50.1 (0.8) | −0.2 | −0.2 | 32 (25) | 50.1 (0.7) | −0.2 | −0.1 | |
6 months | Total | 33 | 49.8 (0.6) | 0.4 | −0.2 | 44 | 50.1 (0.7) | −0.2 | 0.0 | 55 | 50.1 (0.9) | −0.1 | −0.1 |
Men | 18 (55) | 50.0 (0.6) | 0.4 | −0.4 | 25 (57) | 50.1 (0.5) | −0.1 | 0.1 | 27 (49) | 50.1 (0.7) | 0.0 | −0.1 | |
Women | 15 (45) | 49.7 (0.5) | 0.3 | 0.2 | 19 (43) | 50.0 (0.9) | −0.4 | −0.2 | 28 (51) | 50. (1.0) | −0.2 | 0.0 | |
9 months | Total | 30 | 49.6 (0.8) | 0.1 | −0.3 | 37 | 50.4 (1.0) | 0.1 | 0.3 | 44 | 50.0 (1.0) | −0.2 | −0.1 |
Men | 18 (60) | 49.5 (0.9) | 0.0 |
−0.5
| 20 (54) | 50.3 (0.8) | 0.2 | 0.3 | 18 (44) | 49.7 (0.8) |
−0.5
| −0.4 | |
Women | 12 (40) | 49.8 (0.5) | 0.4 | 0.1 | 17 (46) | 50.4 (1.1) | 0.0 | 0.4 | 26 (59) | 50.2 (1.1) | 0.0 | 0.1 | |
12 months | Total | 21 | 49.7 (0.7) | 0.2 | 0.1 | 42 | 50.3 (0.9) | 0.0 | −0.1 | 49 | 49.9 (0.7) | −0.4 | −0.1 |
Men | 13 (62) | 49.7 (0.8) | 0.2 | 0.2 | 21 (50) | 50.4 (0.9) | 0.2 | 0.0 | 23 (47) | 50.0 (0.6) | −0.2 | 0.3 | |
Women | 8 (38) | 49.6 (0.5) | 0.2 | −0.4 | 21 (50) | 50.2 (0.9) | −0.2 | −0.2 | 26 (53) | 49.8 (0.8) |
−0.5
| −0.4 |
Participants
|
Treated for tuberculosis disease
|
Treated for latent tuberculosis infection
|
Screened for tuberculosis but healthy and untreated
| ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
VISIT
|
BY SEX
|
N (%)
|
Mean score (Standard Deviation)
|
Effect Size
1
a
|
Effect Size
2
b
|
N (%)
|
Mean score (Standard Deviation)
|
Effect Size
1
a
|
Effect Size
2
b
|
N (%)
|
Mean score (Standard Deviation)
|
Effect Size
1
a
|
Effect Size
2
b
|
Baseline | Total | 33 | 47.2 (6.5) | - | - | 81 | 50.6 (4.7) | - | - | 91 | 51.7 (4.3) | - | - |
Men | 19 (58) | 46.7 (7.6) | - | - | 37 (46) | 52.0 (3.2) | - | - | 41 (45) | 52.8 (3.5) | - | - | |
Women | 14 (42) | 48.0 (4.9) | - | - | 44 (54) | 49.4 (5.4) | - | - | 50 (55) | 50.7 (4.8) | - | - | |
1 month | Total | 36 | 50.9 (5.6) |
0.6
| - | 58 | 50.1 (5.2) | −0.1 | - | 75 | 52.0 (4.3) | 0.1 | - |
Men | 21 (58) | 49.6 (5.4) | 0.4 | - | 22 (38) | 51.6 (3.9) | −0.1 | - | 38 (51) | 52.0 (4.3) | −0.2 | - | |
Women | 15 (42) | 52.8 (5.5) |
0.9
| - | 36 (62) | 49.3 (5.6) | 0.0 | - | 37 (49) | 51.9 (4.3) | 0.3 | - | |
2 months | Total | 39 | 52.2 (4.6) |
0.9
| 0.3 | 52 | 51.0 (4.7) | 0.1 | 0.2 | 77 | 52.1 (4.1) | 0.1 | 0.0 |
Men | 23 (59) | 51.0 (4.9) |
0.7
| 0.3 | 23 (44) | 52.4 (2.9) | 0.1 | 0.2 | 37 (48) | 52.6 (4.0) | −0.1 | 0.1 | |
Women | 16 (41) | 54.1 (3.5) |
1.4
| 0.3 | 29 (56) | 49.8 (5.5) | 0.1 | 0.1 | 40 (52) | 51.6 (4.3) | 0.2 | −0.1 | |
4 months | Total | 32 | 50.8 (6.6) |
0.5
| −0.3 | 53 | 51.1 (4.2) | 0.1 | 0.0 | 56 | 52.1 (3.4) | 0.1 | 0.0 |
Men | 19 (59) | 49.1 (7.4) | 0.3 | −0.3 | 26 (49) | 52.5 (3.6) | 0.1 | 0.0 | 24 (43) | 52.0 (3.6) | −0.2 | −0.1 | |
Women | 13 (41) | 53.2 (4.4) |
1.1
| −0.2 | 27 (51) | 49.8 (4.4) | 0.1 | 0.0 | 32 (57) | 52.1 (3.3) | 0.3 | 0.1 | |
6 months | Total | 33 | 51.5 (5.8) |
0.7
| 0.1 | 44 | 51.5 (3.9) | 0.2 | 0.1 | 55 | 51.9 (4.1) | 0.1 | 0.0 |
Men | 18 (55) | 50.9 (5.9) |
0.6
| 0.3 | 25 (57) | 52.5 (2.6) | 0.2 | 0.0 | 27 (49) | 52.0 (3.8) | −0.2 | 0.0 | |
Women | 15 (45) | 52.2 (5.7) |
0.8
| −0.2 | 19 (43) | 50.2 (5.0) | 0.1 | 0.1 | 28 (51) | 51.7 (4.5) | 0.2 | −0.1 | |
9 months | Total | 30 | 53.6 (3.5) |
1.2
| 0.4 | 37 | 50.9 (4.8) | 0.1 | −0.1 | 44 | 52.0 (5.3) | 0.1 | 0.0 |
Men | 18 (60) | 53.2 (4.1) |
1.1
|
0.5
| 20 (54) | 51.6 (3.8) | −0.1 | −0.3 | 18 (41) | 53.4 (2.7) | 0.2 | 0.4 | |
Women | 12 (40) | 54.0 (2.6) |
1.5
| 0.4 | 17 (46) | 50.2 (5.7) | 0.1 | 0.0 | 26 (59) | 50.9 (6.4) | 0.0 | −0.1 | |
12 months | Total | 21 | 54.3 (2.9) |
1.4
| 0.2 | 42 | 51.3 (4.5) | 0.1 | 0.1 | 49 | 52.9 (4.1) | 0.3 | 0.2 |
Men | 13 (62) | 53.9 (2.4) |
1.3
| 0.2 | 21 (50) | 51.2 (4.4) | −0.2 | −0.1 | 23 (47) | 53.2 (2.8) | 0.1 | −0.1 | |
Women | 8 (38) | 54.8 (3.7) |
1.6
| 0.3 | 21 (50) | 51.4 (4.7) | 0.4 | 0.2 | 26 (53) | 52.5 (5.0) | 0.4 | 0.3 |
Findings from multivariable analyses of component summary scores
Visit
|
Crude estimate
|
Adjusted estimate
a
|
95% Confidence interval adjusted estimate
|
P-value*
|
---|---|---|---|---|
Baseline | ||||
Tuberculosis disease | 49.5 | 50.0 | 49.5 - 50.5 | 0.001* |
Latent tuberculosis infection | 50.3 | 50.6 | 50.3 - 51.0 | 0.37 |
Controlb
| 50.2 | 50.7 | 50.1 - 51.2 | - |
1 month of treatment | ||||
Tuberculosis disease | 49.5 | 49.9 | 49.4 - 50.5 | 0.90 |
Latent tuberculosis infection | 50.2 | 50.5 | 50.1 - 50.9 | 0.98 |
Control | 50.2 | 50.7 | 50.1 - 51.3 | - |
2 months of treatment | ||||
Tuberculosis disease | 49.5 | 50.0 | 49.4 - 50.5 | 0.45 |
Latent tuberculosis infection | 50.3 | 50.6 | 50.2 - 51.0 | 0.95 |
Control | 50.2 | 50.8 | 50.3 - 51.3 | - |
4 months of treatment | ||||
Tuberculosis disease | 50.0 | 50.4 | 49.8 - 51.0 | 0.89 |
Latent tuberculosis infection | 50.1 | 50.4 | 50.0 - 50.8 | 0.90 |
Control | 50.1 | 50.8 | 50.2 - 51.5 | - |
6 months of treatment | ||||
Tuberculosis disease | 49.7 | 50.2 | 49.7 - 50.7 | 0.89 |
Latent tuberculosis infection | 50.1 | 50.5 | 50.0 - 50.9 | 0.96 |
Control | 50.1 | 50.8 | 50.3 - 51.4 | - |
9 months of treatment | ||||
Tuberculosis disease | 49.6 | 49.9 | 49.3 - 50.5 | 0.09 |
Latent tuberculosis infection | 50.3 | 50.6 | 50.2 - 51.1 | 0.90 |
Control | 50.1 | 51.1 | 50.5 - 51.8 | - |
12 months of treatment | ||||
Tuberculosis disease | 49.6 | 50.1 | 49.5 - 50.6 | 0.04* |
Latent tuberculosis infection | 50.2 | 50.6 | 50.1 - 51.0 | 0.50 |
Control | 50.0 | 50.7 | 50.1 - 51.3 | - |
Visit
|
Crude estimate
|
Adjusted estimate
a
|
95% Confidence interval adjusted estimate
|
P-value*
|
---|---|---|---|---|
Baseline | ||||
Tuberculosis disease | 47.1 | 46.4 | 44.1 - 48.8 | <0.01* |
Latent tuberculosis infection | 50.5 | 50.5 | 48.5 - 52.4 | 0.07 |
Controlb
| 51.7 | 51.1 | 48.9 - 53.2 | - |
1 month of treatment | ||||
Tuberculosis disease | 50.7 | 50.1 | 47.5 - 52.6 | 0.69 |
Latent tuberculosis infection | 50.2 | 50.2 | 48.0 - 52.3 | 0.72 |
Control | 51.5 | 50.8 | 48.6 - 53.1 | - |
2 months of treatment | ||||
Tuberculosis disease | 51.8 | 51.3 | 48.8 - 53.7 | 0.75 |
Latent tuberculosis infection | 50.5 | 50.6 | 48.5 - 52.8 | 0.86 |
Control | 51.7 | 51.2 | 49.2 - 53.2 | - |
4 months of treatment | ||||
Tuberculosis disease | 50.8 | 50.3 | 47.7 - 52.9 | 0.67 |
Latent tuberculosis infection | 50.9 | 51.0 | 48.8 - 53.1 | 0.67 |
Control | 51.9 | 51.4 | 49.1 - 53.8 | - |
6 months of treatment | ||||
Tuberculosis disease | 51.7 | 51.2 | 48.6 - 53.8 | 0.50 |
Latent tuberculosis infection | 50.7 | 50.7 | 48.5 - 53.0 | 0.52 |
Control | 51.5 | 51.0 | 48.7 - 53.4 | - |
9 months of treatment | ||||
Tuberculosis disease | 54.0 | 53.6 | 50.9 - 56.4 | 0.88 |
Latent tuberculosis infection | 50.5 | 50.5 | 48.1 - 52.9 | 0.71 |
Control | 51.4 | 51.0 | 48.5 - 53.5 | - |
12 months of treatment | ||||
Tuberculosis disease | 54.0 | 53.6 | 50.7 - 56.5 | 0.28 |
Latent tuberculosis infection | 50.9 | 50.9 | 48.6 - 53.2 | 0.30 |
Control | 52.2 | 51.7 | 49.3 - 54.2 | - |