Predicting tuberculosis risk in the foreign-born population of British Columbia, Canada: study protocol for a retrospective population-based cohort study

IntroductionImproved understanding of risk factors for developing active tuberculosis (TB) will better inform decisions about diagnostic testing and treatment for latent TB infection (LTBI) in migrant populations in low-incidence regions. We aim to examine TB risk factors among the foreign-born popu...

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Bibliographic Details
Published in:BMJ open 2016-11, Vol.6 (11), p.e013488-e013488
Main Authors: Ronald, Lisa A, Campbell, Jonathon R, Balshaw, Robert F, Roth, David Z, Romanowski, Kamila, Marra, Fawziah, Cook, Victoria J, Johnston, James C
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
British Columbia - epidemiology
Citizenship
Cost analysis
Databases, Factual
Datasets
Emigrants and Immigrants
Humans
Immigration
Multivariate Analysis
Noncitizens
Population
Proportional Hazards Models
Public Health
Registries
Research Design
Retrospective Studies
Risk Assessment
Risk Factors
Studies
Tuberculosis
Tuberculosis - ethnology
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Summary:IntroductionImproved understanding of risk factors for developing active tuberculosis (TB) will better inform decisions about diagnostic testing and treatment for latent TB infection (LTBI) in migrant populations in low-incidence regions. We aim to examine TB risk factors among the foreign-born population in British Columbia (BC), Canada, and to create and validate a clinically relevant multivariate risk score to predict active TB.Methods and analysisThis retrospective population-based cohort study will include all foreign-born individuals who acquired permanent resident status in Canada between 1 January 1985 and 31 December 2013 and acquired healthcare coverage in BC at any point during this period. Multiple administrative databases and disease registries will be linked, including a National Immigration Database, BC Provincial Health Insurance Registration, physician billings, hospitalisations, drugs dispensed from community pharmacies, vital statistics, HIV testing and notifications, cancer, chronic kidney disease and dialysis treatment, and all TB and LTBI testing and treatment data in BC. Extended proportional hazards regression will be used to estimate risk factors for TB and to create a prognostic TB risk score.Ethics and disseminationEthical approval for this study has been obtained from the University of British Columbia Clinical Ethics Review Board. Once completed, study findings will be presented at conferences and published in peer-reviewed journals. An online TB risk score calculator will also be created.
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2016-013488