title: Effectiveness of the Immigration Medical Surveillance Program for tuberculosis in Ontario.
abstract: BACKGROUND
  Citizenship and Immigration Canada (CIC) screens immigrants for TB and permits those with inactive pulmonary TB to enter Canada conditionally, subject to medical surveillance; we studied this program in Ontario.
  
  
  METHODS
  This was an administrative database study with linkage of national and provincial data.
  
  
  RESULTS
  In 1994-95, 1,341 cases of foreign-born active TB were diagnosed and a CIC record was found for 1,095. 149 (14%) were classified for surveillance and 142 were included in the analysis. A significant proportion (39/142: 27%) were diagnosed either before or as a result of immigration screening in Canada. These persons had arrived as visitors or refugees and were excluded from further analysis. Only 21 of the remaining 103 persons (20%) with immigration screening before the diagnosis of TB adhered to surveillance. Only 1 of 16 (6%) eligible persons was given therapy to prevent future episodes of active TB. Most presented with symptoms (82/103:82%) suggesting potential for TB transmission in Ontario.
  
  
  CONCLUSIONS
  The current TB surveillance system for high-risk immigrants to Ontario is not effective in identifying and treating latent infection, and thus not effective in preventing future cases.
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON.
authors.forename: Aparna
authors.initials: A
authors.lastname: Uppaluri
authors.forename: Monika
authors.initials: M
authors.lastname: Naus
authors.forename: Neil
authors.initials: N
authors.lastname: Heywood
authors.forename: James
authors.initials: J
authors.lastname: Brunton
authors.forename: Diane
authors.initials: D
authors.lastname: Kerbel
authors.forename: Wendy
authors.initials: W
authors.lastname: Wobeser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*