Optimizing tuberculosis screening for immigrants in southern New Brunswick: A pilot study protocol.

Area of Science:

• Public Health
• Infectious Diseases
• Immigration Health

Background:

• Immigrants from high tuberculosis-burdened countries have an elevated risk of latent tuberculosis infection (LTBI).
• Canada's current immigration medical examination identifies active tuberculosis but not LTBI, posing a risk for developing active disease post-migration.
• Stressful migration experiences can increase the risk of LTBI progression to active tuberculosis in immigrants.

Purpose of the Study:

• To pilot an improved LTBI screening protocol for immigrants from high tuberculosis incidence countries using the QuantiFERON-TB Gold Plus assay (IGRA).
• To offer timely LTBI treatment and support to identified individuals.
• To evaluate the satisfaction of immigrants and healthcare providers (HCPs) with the LTBI screening pilot program.

Main Methods:

• A cross-sectional pilot study recruiting 288 participants through various outreach methods.
• LTBI screening using IGRA (QuantiFERON-TB Gold Plus) blood test, with clinical assessment and treatment offered for positive cases.
• Quantitative analysis of participant characteristics and feedback using descriptive statistics and logistic regression; qualitative analysis of feedback using thematic analysis.

Main Results:

• The study will assess the feasibility and acceptability of the IGRA LTBI screening assay among immigrants and HCPs in New Brunswick.
• It will identify factors influencing the IGRA test outcome and immune responses.
• The study will provide insights into the facilitators and barriers of LTBI screening and management.

Conclusions:

• Findings will inform the potential expansion of LTBI screening programs for immigrants.
• This pilot study contributes to better prevention and management of tuberculosis cases within immigrant populations.
• Understanding immigrant and HCP satisfaction is crucial for successful program implementation and scalability.