Health Analysis Division, Statistics Canada, Ottawa, Ontario.
Migration Health Branch, Immigration, Refugees and Citizenship Canada, Ottawa, Ontario.
Health Rep. 2018 Jul 18;29(7):14-28.
While the incidence of active tuberculosis (TB) in Canada is among the lowest in the world, the rates of TB among immigrants and Indigenous people remain high. In fact, the majority of new active TB cases are disproportionately found among immigrants. This study profiles TB-related acute care hospitalizations among new immigrants to Canada by selected characteristics.
This study is based on the 2000-to-2013 Longitudinal Immigration Database (IMDB) linked to the Canadian Institute for Health Information's Discharge Abstract Database (DAD) from 2001/2002 to 2013/2014. It examines the timing of first TB-related acute care hospitalization occurring from the fiscal year 2001/2002 to the fiscal year 2013/2014 among immigrants who landed in Canada from 2000 to 2013 outside of Quebec and the territories. Mean and median hospital days and the percentage of total TB hospitalizations incurred by these new immigrants are calculated to measure the burden of hospital care among recent immigrants.
From 2001/2002 to 2013/2014, 1,120 out of 2.7 million immigrants arriving between 2000 and 2013 were found to have, in total, 1,340 TB-related hospital discharges. The majority of cases (97%) were among immigrants from the Immigration, Refugees and Citizenship Canada (IRCC) designated country list for TB, in which abour three quarters of the cases were from the World Health Organization (WHO) list of high TB-burden countries. Approximately half (45%) of immigrants hospitalized for TB were aged 18 to 34 at the time of hospitalization. Around 10% of all TB patients had been hospitalized before formally landing as immigrants. Mean and median length of hospital stay were 17 days and 11 days, respectively (22 days and 14 days, respectively, for the overall population in Canada). While new immigrants who landed between 2000 and 2013 represent 7% of the overall population of Canada, they incurred 17% of all TB-related hospital discharges occurring during this period.
This paper demonstrates the value of linked administrative data to understanding immigrant health and is important for future work in this area. Current immigration protocols surrounding TB involve screening for active pulmonary TB and identifying some migrants with latent TB. Results of this study, linking TB-related hospitalizations to immigrant landing files, provide unique information that can inform public health action, as well as migration policy and program development to contribute to the efforts to eliminate TB.
尽管加拿大的活动性肺结核（TB）发病率处于世界最低水平，但移民和原住民中的 TB 发病率仍然很高。事实上，大多数新的活动性 TB 病例主要出现在移民中。本研究按选定特征分析新移民到加拿大后的与 TB 相关的急性护理住院情况。
本研究基于 2000 年至 2013 年的纵向移民数据库（IMDB），该数据库与加拿大卫生信息研究所的 2001/2002 年至 2013/2014 年的出院摘要数据库（DAD）相关联。研究检查了 2000 年至 2013 年期间在魁北克省和其他地区以外登陆加拿大的移民在 2001/2002 财年至 2013/2014 财年期间首次与 TB 相关的急性护理住院的时间。计算新移民的平均和中位数住院天数以及这些移民住院治疗的 TB 总住院率，以衡量最近移民的住院护理负担。
从 2001/2002 年至 2013/2014 年，在 2000 年至 2013 年期间抵达的 270 万移民中，有 1120 人总计有 1340 例与 TB 相关的住院出院。大多数病例（97%）来自加拿大移民、难民和公民事务部（IRCC）指定的结核病国家名单，其中约四分之三的病例来自世界卫生组织（WHO）高结核病负担国家名单。约有一半（45%）因结核病住院的移民在住院时年龄在 18 至 34 岁之间。大约 10%的所有结核病患者在正式成为移民之前曾住院治疗。平均和中位数住院时间分别为 17 天和 11 天（加拿大总人口分别为 22 天和 14 天）。尽管 2000 年至 2013 年期间登陆的新移民仅占加拿大总人口的 7%，但他们却占这期间所有与 TB 相关的住院出院人数的 17%。
本文展示了关联行政数据对了解移民健康状况的价值，这对该领域的未来工作很重要。当前围绕结核病的移民协议涉及筛查活动性肺结核和识别一些潜伏性结核移民。这项将与结核病相关的住院治疗与移民登陆档案联系起来的研究结果提供了独特的信息，可以为公共卫生行动提供信息，也可以为移民政策和方案制定提供信息，为消除结核病的努力做出贡献。
