Cowie R L, Sharpe J W
Tuberculosis Services for Southern Alberta, Foothills Provincial General Hospital, Calgary, Alta.
CMAJ. 1998 Mar 10;158(5):599-602.
To examine the pattern of tuberculosis (TB) occurring among immigrants and the interval from arrival in Canada to diagnosis of the disease.
Study of all cases of TB diagnosed in foreign-born residents of southern Alberta during the 5-year period 1990-1994.
A centre for the diagnosis, management and control of all cases of TB in the southern half of the province of Alberta.
All foreign-born patients in whom TB was newly diagnosed between January 1990 and December 1994 were included in the study. The interval from their arrival in Canada to diagnosis, their country of birth and the site of their disease were documented.
Immigrants to Canada accounted for 248 (70.6%) of the 351 cases of TB diagnosed in southern Alberta during the 5-year period. The majority of these immigrants (182/248 [73.4%]) were of Asian origin. Extrapulmonary TB accounted for 111 (61.0%) of the 182 cases of the disease in Asian immigrants. The mean period between immigration and diagnosis was 11.2 years (standard deviation [SD] 13.9 years). Half of the patients presented within 7 years of their arrival in Canada. The time to presentation was shortest for patients with superficial lymph node disease (mean 7.6 years [SD 6.9] after arrival), intermediate among those with extrapulmonary disease, excluding superficial disease of the lymph node (10.1 years [SD 12.1]), and longest for those with pulmonary disease (14.2 years [SD 17.2]). TB developed sooner after arrival in Canada among immigrants from Asian countries (mean 9.1 years) than among those from other countries (17.2 years) (p = 0.01).
Given the low annual incidence of TB in Canada (7.1 per 100,000), it is probable that TB occurring among immigrants reflects infection acquired before arrival in Canada. Health care professionals need to be aware that immigrants from countries with a relatively high prevalence of TB remain at risk for the disease (often at an extrapulmonary site) for many years after they immigrate to low-prevalence countries.
研究移民中结核病（TB）的发病模式以及从抵达加拿大到疾病诊断的间隔时间。
对1990 - 1994年5年间在艾伯塔省南部出生于国外的居民中诊断出的所有结核病病例进行研究。
艾伯塔省南部所有结核病病例的诊断、管理和控制中心。
纳入1990年1月至1994年12月期间新诊断出结核病的所有出生于国外的患者。记录他们从抵达加拿大到诊断的间隔时间、出生国家和疾病部位。
在这5年期间，艾伯塔省南部诊断出的351例结核病病例中，移民占248例（70.6%）。这些移民中的大多数（182/248 [73.4%]）来自亚洲。肺外结核占亚洲移民中182例该疾病病例的111例（61.0%）。移民与诊断之间的平均时间为11.2年（标准差[SD] 13.9年）。一半的患者在抵达加拿大后的7年内发病。浅表淋巴结疾病患者发病时间最短（抵达后平均7.6年[SD 6.9]），肺外疾病患者（不包括浅表淋巴结疾病）发病时间居中（10.1年[SD 12.1]），肺部疾病患者发病时间最长（14.2年[SD 17.2]）。来自亚洲国家的移民抵达加拿大后结核病发病时间（平均9.1年）比来自其他国家的移民（17.2年）更早（p = 0.01）。
鉴于加拿大结核病的年发病率较低（每10万人中7.1例），移民中发生的结核病很可能反映了在抵达加拿大之前获得的感染。医疗保健专业人员需要意识到，来自结核病患病率相对较高国家的移民在移民到低患病率国家多年后仍有患该疾病（通常是肺外部位）的风险。
