Post-migration follow-up programme for migrants at increased risk of developing tuberculosis: a cohort study

Nishta Kaushik, Chris Lowbridge, Gabriella Scandurra, Claudia C Dobler

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Abstract

Following pre-migration screening for tuberculosis (TB), migrants who are deemed to be at a high risk of developing TB must attend post-entry follow-up in Australia. We aimed to evaluate the effectiveness of post-migration TB follow-up in the state of New South Wales to diagnose TB in these high-risk migrants. In this retrospective cohort study, we assessed the risk of TB in migrants who arrived in New South Wales between 2000 and 2015 and were referred for post-migration follow-up. Clinical notes were examined for a nested cohort to determine whether TB was diagnosed via the follow-up programme or via passive case finding. Of the 32 550 migrants referred for follow-up, 428 (1.3%) developed TB. The incidence of TB was 436 per 100 000 person-years (95% CI 384-491 per 100 000 person-years) in the first 2 years after arrival and 128 per 100 000 person-years (95% CI 116-140 per 100 000 person-years) over the mean study observation period of 10.3 years. An estimated 63% of cases were diagnosed via follow-up. TB notifications occurred 0.55 years earlier since time of arrival in Australia in migrants who attended follow-up than in those who did not. Post-migration follow-up detected 63% of TB cases in high-risk migrants and potentially prevented delay of TB diagnosis.

Original languageEnglish
JournalERJ Open Research
Volume4
Issue number3
DOIs
Publication statusPublished - Jul 2018
Externally publishedYes

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Tuberculosis
Cohort Studies
New South Wales
Retrospective Studies
Observation
Incidence

Cite this

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title = "Post-migration follow-up programme for migrants at increased risk of developing tuberculosis: a cohort study",
abstract = "Following pre-migration screening for tuberculosis (TB), migrants who are deemed to be at a high risk of developing TB must attend post-entry follow-up in Australia. We aimed to evaluate the effectiveness of post-migration TB follow-up in the state of New South Wales to diagnose TB in these high-risk migrants. In this retrospective cohort study, we assessed the risk of TB in migrants who arrived in New South Wales between 2000 and 2015 and were referred for post-migration follow-up. Clinical notes were examined for a nested cohort to determine whether TB was diagnosed via the follow-up programme or via passive case finding. Of the 32 550 migrants referred for follow-up, 428 (1.3{\%}) developed TB. The incidence of TB was 436 per 100 000 person-years (95{\%} CI 384-491 per 100 000 person-years) in the first 2 years after arrival and 128 per 100 000 person-years (95{\%} CI 116-140 per 100 000 person-years) over the mean study observation period of 10.3 years. An estimated 63{\%} of cases were diagnosed via follow-up. TB notifications occurred 0.55 years earlier since time of arrival in Australia in migrants who attended follow-up than in those who did not. Post-migration follow-up detected 63{\%} of TB cases in high-risk migrants and potentially prevented delay of TB diagnosis.",
author = "Nishta Kaushik and Chris Lowbridge and Gabriella Scandurra and Dobler, {Claudia C}",
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Post-migration follow-up programme for migrants at increased risk of developing tuberculosis : a cohort study. / Kaushik, Nishta; Lowbridge, Chris; Scandurra, Gabriella; Dobler, Claudia C.

In: ERJ Open Research, Vol. 4, No. 3, 07.2018.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Dobler, Claudia C

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AB - Following pre-migration screening for tuberculosis (TB), migrants who are deemed to be at a high risk of developing TB must attend post-entry follow-up in Australia. We aimed to evaluate the effectiveness of post-migration TB follow-up in the state of New South Wales to diagnose TB in these high-risk migrants. In this retrospective cohort study, we assessed the risk of TB in migrants who arrived in New South Wales between 2000 and 2015 and were referred for post-migration follow-up. Clinical notes were examined for a nested cohort to determine whether TB was diagnosed via the follow-up programme or via passive case finding. Of the 32 550 migrants referred for follow-up, 428 (1.3%) developed TB. The incidence of TB was 436 per 100 000 person-years (95% CI 384-491 per 100 000 person-years) in the first 2 years after arrival and 128 per 100 000 person-years (95% CI 116-140 per 100 000 person-years) over the mean study observation period of 10.3 years. An estimated 63% of cases were diagnosed via follow-up. TB notifications occurred 0.55 years earlier since time of arrival in Australia in migrants who attended follow-up than in those who did not. Post-migration follow-up detected 63% of TB cases in high-risk migrants and potentially prevented delay of TB diagnosis.

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