[Tuberculosis in aged persons residing in Quebec facilities: are screening and chemoprophylaxis indicated?].
OBJECTIVE
Different strategies for the prevention and control of tuberculosis in facilities providing long-term care (LTCF) to the elderly were proposed by the U.S. Public Health Service (USPHS) and the Quebec Ministry of Health and Social Services (MHSS). Controversies regarding the screening and chemoprophylaxis of tuberculosis in the elderly were reviewed, the epidemiology of tuberculosis in the United States and Quebec was compared and the number of cases expected annually was estimated from estimates available in the literature.


METHODS
Fifty-five scientific articles and official documents identified in the Medline database were analyzed.


RESULTS
U.S. epidemiologic data support screening and chemoprophylaxis but in Quebec, the absence of reported increased risk in LTCF explains the reservations of the MHSS. According to our estimates, expected cases of tuberculosis might be underestimated.


CONCLUSIONS
In Quebec, the best strategy to control tuberculosis is not yet obvious. A precise estimation of the number of undiagnosed cases in this environment would help clarify the dilemma.
D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D006301:Health Services Needs and Demand; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000379:methods*; D011634:Public Health; D011792:Quebec / Q000453:epidemiology; D012866:Skilled Nursing Facilities; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology
D000995:Antitubercular Agents
Tuberculose chez les personnes âgées résidant en établissements au Québec: le dépistage et la chimioprophylaxie sont-ils indiqués?