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- Title
Contact investigation outcomes of Canadian-born adults with tuberculosis in Indigenous and non-Indigenous populations in Alberta.
- Authors
Eisenbeis, Lisa; Zhiwei Gao; Heffernan, Courtney; Yacoub, Wadieh; Long, Richard; Verma, Geetika; Gao, Zhiwei
- Abstract
<bold>Objectives: </bold>Contact investigations are a critical component of tuberculosis control in high-income countries. However, the relative success of conventional methods by population group and place of residence is unknown. This study compares outcomes of contact investigations of Canadian-born Indigenous tuberculosis cases living on- and off-reserve with other Canadian-born cases.<bold>Methods: </bold>In a retrospective analysis, Canadian-born adult culture-positive pulmonary TB cases (2001-2010) were identified. Characteristics of source cases and their contacts were compared by population group. Outcomes of contact investigations, including completion of recommended investigations and preventive therapy, were compared in multivariable analysis.<bold>Results: </bold>Of 171 cases of tuberculosis identified, 49 (29%) were Indigenous on-reserve, 62 (36%) Indigenous off-reserve, and 60 (35%) non-Indigenous or Canadian-born, "other". Indigenous people had more contacts identified per case compared to non-Indigenous patients. Case population group and smear status were the main predictors of the success of contact investigations. Of those recommended preventive therapy, close contacts of Indigenous cases on-reserve had the highest rate of completion, at 54%, vs. 41% and 37% for close contacts of Indigenous living off-reserve and Canadian-born "other" respectively (p = 0.02). Contacts of Indigenous cases living off-reserve had the greatest delay in assessment and the lowest rates of completion of assessment and preventive therapy. In multivariable analysis, population group, smear status of source case and proximity of contact were predictors of preventive therapy acceptance and/or completion.<bold>Conclusions: </bold>Significant differences in outcomes of contact investigations were observed between population groups. The higher priority of contacts of smear-positive cases appears to influence efficiency of service delivery, regardless of population group. Jurisdictional differences in program delivery, resource availability and perceived risk of transmission likely influence outcomes of contact investigations.
- Subjects
ALBERTA; STATISTICS on Native Americans; TUBERCULOSIS prevention; TUBERCULOSIS epidemiology; COMPARATIVE studies; ESKIMOS; INDIGENOUS peoples; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESIDENTIAL patterns; EVALUATION research; RETROSPECTIVE studies; CONTACT tracing
- Publication
Canadian Journal of Public Health, 2016, Vol 107, Issue 1, pe106
- ISSN
0008-4263
- Publication type
journal article
- DOI
10.17269/cjph.107.5255