Division of Community Health & Humanities, Health Sciences Centre, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada.
J Immigr Minor Health. 2012 Feb;14(1):6-13. doi: 10.1007/s10903-011-9506-1.
Current tuberculosis control strategies in Canada rely exclusively on screening and surveillance of immigrants. This is consistent with current public health discourse that attributes the high burden of immigrant tuberculosis to the exposure of immigrants to infection in their country of origin. The effectiveness of control strategies is questionable given the evidence that many immigrants are at higher risk of tuberculosis reactivation because of risk factors such as poverty, malnutrition and overcrowded housing. This paper argues that the absence of policies that address poverty-related disadvantages among immigrants makes these populations more vulnerable to the reactivation of their tuberculosis long after they have been exposed in their countries of birth. Policies for tuberculosis prevention in the Aboriginal population attend to their poverty and other social determinants of health. Effective health prevention policy for tuberculosis within the immigrant population must take similar direction.
加拿大目前的结核病控制策略完全依赖于对移民的筛查和监测。这与当前的公共卫生话语一致，即认为移民结核病负担沉重是由于移民在原籍国接触感染所致。鉴于许多移民因贫困、营养不良和住房拥挤等风险因素而面临更高的结核病复发风险的证据，控制策略的有效性值得怀疑。本文认为，缺乏针对移民中与贫困相关的不利因素的政策，使得这些人群在其出生国接触感染后很长一段时间内更容易结核病复发。针对原住民人群的结核病预防政策关注他们的贫困和其他健康决定因素。针对移民人群的结核病有效健康预防政策必须采取类似的方向。
