Table 1:
Cases of tuberculosis detected through preimmigration screening (2008–2011) and postimmigration surveillance (2002–2011), by region
| Measure | Region of origin | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| USA | Australia and New Zealand | Western Europe | Middle East and North Africa | Pacific Islands | Latin America and Caribbean | Eastern Europe and Central Asia | East Asia | South Asia | Sub-Saharan Africa | Total | |
| Incidence rate* | 5.5 | 6.9 | 13.3 | 27.4 | 48.0 | 49.7 | 104.2 | 160.8 | 198.5 | 292.8 | 137.0 |
| Preimmigration screening (2008–2011) | |||||||||||
| No. of preimmigration medicals† | 11 224 | 1 063 | 15 612 | 47 427 | 79 | 38 967 | 22 530 | 84 498 | 91 547 | 21 372 | 334 319 |
| No. of cases (pulmonary) detected | 0 | 0 | 0 | 2 | 0 | 1 | 2 | 85 | 61 | 6 | 157 |
| No. of preimmigration medicals per case (pulmonary) detected | NA | NA | NA | 23 714 | NA | 38 967 | 11 265 | 994 | 1 501 | 3 562 | 2 129 |
| Postimmigration surveillance (2002–2011) | |||||||||||
| No. of preimmigration medicals‡ | 28 501 | 2 605 | 35 886 | 113 093 | 303 | 97 646 | 86 960 | 236 740 | 283 016 | 59 625 | 944 375 |
| No. of postimmigration surveillance referrals | 127 | 11 | 317 | 875 | 2 | 998 | 2 249 | 10 196 | 6 256 | 1 360 | 22 391 |
| No. of preimmigration medicals per surveillance referral | 224.4 | 236.8 | 113.2 | 129.2 | 151.5 | 97.8 | 38.7 | 23.2 | 45.2 | 43.8 | 42.2 |
| No. of patients who complied with surveillance | 91 | 8 | 172 | 490 | 0 | 653 | 1 098 | 6 315 | 3 724 | 836 | 13 387 |
| No. of cases (all sites) detected within 2 yr of immigration | 0 | 0 | 0 | 4 | 0 | 11 | 16 | 156 | 214 | 101 | 502 |
| No. of cases (all sites) potentially detectable§ through surveillance | 0 | 0 | 0 | 3 | 0 | 2 | 5 | 67 | 74 | 17 | 168 |
| No. of cases (all sites) actually detected through surveillance | 0 | 0 | 0 | 3 | 0 | 2 | 4 | 46 | 38 | 9 | 102 |
| No. of preimmigration medicals per potentially detectable§ case | NA | NA | NA | 37 698 | NA | 48 823 | 17 392 | 3 533 | 3 825 | 3 507 | 5 621 |
| No. of preimmigration medicals per actually detected case | NA | NA | NA | 37 698 | NA | 48 823 | 21 740 | 5 147 | 7 448 | 6 625 | 9 259 |
| No. of postimmigration surveillance referrals per potentially detectable§ case | NA | NA | NA | 291.7 | NA | 499.0 | 449.8 | 152.2 | 84.5 | 80.0 | 133.3 |
| No. of postimmigration surveillance referrals per actually detected case | NA | NA | NA | 291.7 | NA | 499.0 | 562.3 | 221.7 | 164.6 | 151.1 | 219.5 |
Note: NA = undefined values where no cases were detected.
Calculated by weighting the World Health Organization–reported national tuberculosis incidence rate for each birth country in the year of immigration by the corresponding number of immigrants.
Outcome data for preimmigration screening reflect the period between 2008 and 2011 (n = 334 319 medicals given to people who became permanent residents). Given the purpose of preimmigration screening to detect communicable diseases, only pulmonary tuberculosis cases were reported.
Outcome data for postimmigration surveillance reflect the period between 2002 and 2011 (n = 944 375 medicals given to people who became permanent residents).
Potentially detectable tuberculosis was defined as active disease developing at any site within 2 years of immigration among people who were referred to postimmigration surveillance.