title: Challenges to tuberculin screening and follow-up in an urban Aboriginal sample in Montreal, Canada.
abstract: We sought to describe the prevalence and predictors of tuberculin skin test (TST) reactors in a high-risk sample of urban Aboriginal people, and to evaluate adherence to medical evaluation and latent tuberculosis infection (LTBI) treatment among those with TST reactivity. Of the 164 participants tested, 86% returned for TST reading. Positive TST reactions (>or=10 mm) were observed in 17.7% (25/141, 95% CI 11.4-24.0) of participants, and were associated with older age (OR per 10 year increase 1.8, 95% CI 1.2-2.7) and Inuit Aboriginal group (OR 2.8, 95% CI 1.1-7.3). Only four participants presented for evaluation, of whom one initiated and none completed LTBI treatment. Tuberculin screening in this population can be an effective strategy for identifying TST reactive individuals; however, screening efforts will have minimal impact without additional efforts in this high-risk group.
authors.affiliation: Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, and Royal Victoria Hospital, Montreal, Canada. paul.brassard@clinepi.mcgill.ca
authors.forename: Paul
authors.initials: P
authors.lastname: Brassard
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Anderson
authors.forename: Kevin
authors.initials: K
authors.lastname: Schwartzman
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Macdonald
authors.forename: Dick
authors.initials: D
authors.lastname: Menzies
mesh_terms: D000328:Adult; D000367:Age Factors; D000995:Antitubercular Agents / Q000627:therapeutic use; D002170:Canada; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D014374:Tuberculin Test / Q000706:statistics & numerical data*; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D000995:Antitubercular Agents