Balancing prevention and screening among international migrants with tuberculosis: Population mobility as the major epidemiological influence in low-incidence nations

Public Health

Volumn 120, Issue 8, 2006, Pages 712-723

  MacPherson, D W ^a,b   Gushulak, B D ^a  

^a Migration Health Consultants Inc   (Austria)

^b MCMASTER UNIVERSITY   (Canada)

Author keywords

Immigration; Migration; Policy; Prevalence gaps; Screening; Tuberculosis

Indexed keywords

TUBERCULOSTATIC AGENT;

DISEASE CONTROL; DISEASE PREVALENCE; HEALTH POLICY; IMMIGRANT POPULATION; IMMIGRATION POLICY; MEDICAL GEOGRAPHY; RISK FACTOR; TUBERCULOSIS;

ARTICLE; DEVELOPING COUNTRY; ENDEMIC DISEASE; EVIDENCE BASED MEDICINE; HEALTH PROGRAM; HUMAN; INCIDENCE; INCOME; LUNG TUBERCULOSIS; MIGRATION; MORBIDITY; MORTALITY; MYCOBACTERIUM TUBERCULOSIS; NONHUMAN; POLICY; POPULATION MOVEMENT PATTERN; PREVALENCE; SCREENING; SUPERINFECTION; TUBERCULOSIS CONTROL;

DRUG RESISTANCE, MULTIPLE, BACTERIAL; EMIGRATION AND IMMIGRATION; HUMANS; INCIDENCE; MASS CHEST X-RAY; RESIDENTIAL MOBILITY; TUBERCULOSIS, PULMONARY; WORLD HEALTH;

EID: 33746349231     PISSN: 00333506     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.puhe.2006.05.002     Document Type: Article

References (113)

1. Osler W. On the study of tuberculosis. The Philadelphia Med J 1900;1-5.
2. Rieder H.L. Epidemiologic basis of tuberculosis control. 1st ed (1999), International Union against Tuberculosis and Lung Disease, Paris
3. WHO. The global plan to stop TB 2006-2015. Geneva: The World Health Organization, 2006. Available from http://www.who.int/tb/publications/global_plan_to_stop_tb/en/index.html. (accessed 3 May 2006).
4. van Soolingen D., Borgdorff M.W., de Haas P.E., Sebek M.M., Veen J., Dessens M., et al. Molecular epidemiology of tuberculosis in the Netherlands: a nationwide study from 1993 through 1997. J Infect Dis 180 (1999) 726-736
5. Committee on Migration, Refugees and Population, Parliamentary Assembly Council of Europe. Migration and integration: a challenge and an opportunity for Europe. Document 10453. February 2005. Available from url: http://assembly.coe.int/Documents/WorkingDocs/Doc05/EDOC10453.htm (accessed 3 May 2006).
6. Diel R., Meywald-Walter K., Gottschalk R., Rusch-Gerdes S., and Niemann S. Ongoing outbreak of tuberculosis in a low-incidence community: a molecular-epidemiological evaluation. Int J Tuberc Lung Dis 8 (2004) 855-861
7. Nguyen D., Proulx J- F., Westley J., Thibert L., Dery S., and Behr M.A. Tuberculosis in the nuit Community of Quebec, Canada. Am J Respir Crit Care Med 168 (2003) 1353-1357
8. Lutz W., O'Neill B.C., and Scherbov S. Europe's population at a turning point. Science 299 (2003) 1991-1993
9. Robinson W.C. Terms of refuge: the Indochinese exodus and the international response (1998), Zed Books, London
10. Vitkovskaya G. Post-Soviet migrations, the Geneva process, and civil society in Russia. Briefing Paper. Migration and Citizenship Program, volume 2, issue 08. Moscow: Carneigie Endowment for Inernational Peace, 2000, Available from http://www.carnegie.ru/en/pubs/briefings/48351.htm (accessed 3 May 2006).
11. Castles S., and Davidson A. Citizenship and migration: globalization and the politics of belonging (2000), Routledge, New York
12. Public Health Agency of Canada. Tuberculosis in Canada 2002. Ottawa, 2004. Available from URL; http://www.phac-aspc.gc.ca/publicat/tbcan02/pdf/tbcan_2002_e.pdf (accessed 3 May 2006).
13. CDC. Reported tuberculosis in the United States, 2004. Atlanta, GA: US Department of Health and Human Services, CDC; September 2005. Available from: http://www.cdc.gov/nchstp/tb/surv/surv2004/default.htm (accessed 3 May 2006)
14. UK Health Protection Agency. Pulmonary and non-pulmonary notifications, England and Wales, 1982-2003. Available from htttp://www.hpa.org.uk/infections/topics_az/tb/epidemiology/figures/figure1.htm.
15. Chemtob D., Leventhal A., Berlowitz Y., and Weiler-Ravell D. The new National Tuberculosis Control Programme in Israel, a country of high immigration. Int J Tuberc Lung Dis 7 (2003) 828-836
16. Li J., Roche P., Spencer J., Bastian I., Christensen A., Hurwitz M., et al. National Tuberculosis Advisory Committee Communicable Disease Network Australia. Tuberculosis Notifications in Australia, 2003. Commun Dis Intell 28 (2004) 464-473
17. Anonymous. Technical instructions for medical examination of aliens in the United States. Atlanta, Georgia: US. Department of Health and Human Services, CDC, June 1991. Available from http://www.cdc.gov/ncidod/dq/technica.htm (accessed 3 May 2006).
18. Citizenship and Immigration Canada. Conducting an immigration medical examination. In: Designated medical practitioner handbook, section 6. Available from http://www.cic.gc.ca/english/pub/dmp%2Dhandbook/index.html (accessed 3 May 2006).
19. Australian Government. Department of Immigration and Multicultural and Indigenous Affairs. General visa issues. Health examination-frequently asked questions. Available from http://www.immi.gov.au/faq/general/general03.htm (accessed 3 May 2006).
20. Moreno B. Encyclopaedia of Ellis Island (2004), Greenwood Press, Connecticut
21. Binkin N., Zuber P., Wells C., Tipple M., and Castro K. Overseas screening for tuberculosis in immigrants and refugees to the United States: current status. Clin Infect Dis 26 (1996) 1226-1232
22. Tala E., and Liippo K. Still screening for pulmonary tuberculosis?. Eur Respir J 2 (1989) 397-398
23. Gordin F.M., Slutkin G., Schecter G., Goodman P.C., and Hopewell P.C. Presumptive diagnosis and treatment of pulmonary tuberculosis based on radiographic findings. Am Rev Respir Dis 139 (1989) 1090-1093
24. Rieder H.L., Zellweger J.P., Raviglione M.C., Keizer S.T., and Miglori G.B. Tuberculosis control in Europe and international migration. Eur Respir J 7 (1994) 1545-1553
25. Underwood B.R., White V.L., Baker T., Law M., and Moore-Gillon J.C. Contact tracing and population screening for tuberculosis: who should be assessed?. J Public Health Med 25 (2003) 59-61
26. Mandalakas A., and Starke JR. Tuberculosis screening in immigrant children. Pediatr Infect Dis J 23 (2004) 71-72
27. Lewinsohn D.A., Gennaro M.L., Scholvinck L., and Lewinsohn D.M. Tuberculosis immunology in children: diagnostic and therapeutic challenges and opportunities. Int J Tuberc Lung Dis 8 (2004) 658-674
28. Phillips L., Carlile J., and Smith D. Epidemiology of a tuberculosis outbreak in a rural Missouri high school. Pediatrics 113 (2004) 514-519
29. Feja K., and Saiman L. Tuberculosis in children. Clin Chest Med 26 (2005) 295-312
30. World Health Organization. Global tuberculosis control: surveillance, planning, and financing. WHO Report 2005. WHO/HTM/TB/2005. Available from http://www.who.int/tb/publications/global_report/2005/en/ (accessed 3 May 2006).
31. Recommendations for Prevention and Control of Tuberculosis Among Foreign-Born Persons Report of the Working Group on Tuberculosis Among Foreign-Born Persons. MMWR 1998; 47(RR16);1-26. Available from http://wonder.cdc.gov/wonder/prevguid/m0054855/m0054855.asp (accessed 3 May 2006).
32. Lillebaek T., Andersen A.B., Dirksen A., Smith E., Skovgaard L.T., and Kok-Jensen A. Persistent high incidence of tuberculosis in immigrants in a low-incidence country. Emerg Infect Dis 8 (2002) 679-684
33. Public Health Agency of Canada. Tuberculosis among the foreign-born in Canada. CCDR 2003; 29: January 15, 2003. Available from http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/03vol29/dr2902eb.html (accessed 3 May 2006).
34. Li J., et al. Tuberculosis notifications in Australia, 2003. Commun Dis Intell 28 (2004) 464-473
35. Public Health Agency of Canada. Tuberculosis prevention and control. Surveillance Reports. Available from http://www.phac-aspc.gc.ca/tbpc-latb/surv_e.html (accessed 3 May 2006).
36. Farah M.G., Meyer H.E., Selmer R., Heldal E., and Bjune G. Long-term risk of tuberculosis among immigrants in Norway. Int J Epidemiol 34 (2005) 1005-1011
37. Borgdorff M.W., van der Werf M.J., de Haas P.E., Kremer K., and van Soolingen D. Tuberculosis elimination in the Netherlands. Emerg Infect Dis 11 (2005) 597-602
38. CDC. Reported tuberculosis in the United States, 2002. Atlanta, GA: US Department of Health and Human Services, CDC; September 2003.
39. Tuberculosis Section. Health Protection Agency Centre for Infections. London. Annual report on tuberculosis cases reported in England, Wales and Northern Ireland in 2003. December 2005. Available from http://www.hpa.org.uk/infections/topics_az/tb/menu.htm (accessed 3 May 2006).
40. Rieder H.L., Zellweger J.P., Raviglione M.C., Keizer S.T., and Miglori G.B. Tuberculosis control in Europe and international migration. Eur Respir J 7 (1994) 1545-1553
41. Brassard P., Steensma C., Cadieux L., and Lands L.C. Evaluation of a school-based tuberculosis-screening program and associate investigation targeting recently immigrated children in a low-burden country. Pediatrics 117 (2006) 148-156
42. Breuss E., Helbling P., Altpeter E., and Zellweger J.P. Screening and treatment for latent tuberculosis infection among asylum seekers entering Switzerland. Swiss Med Wkly 132 (2002) 197-200
43. Carvalho A.C., Saleri N., El-Hamad I., Tedoldi S., Capone S., Pezzoli M.C., et al. Completion of screening for latent tuberculosis infection among immigrants. Epidemiol Infect 133 (2005) 179-185
44. Marks G.B., Bai J., Stewart G.J., Simpson S.E., and Sullivan E.A. Effectiveness of post-migration screening in controlling tuberculosis among refugees: a historical cohort study, 1984-1998. Am J Public Health 91 (2001) 1797-1799
45. Sterling T.R., Thompson D., Stanley R.L., McElroy P.D., Madison A., Moore K., et al. A multi-state outbreak of tuberculosis among members of a highly mobile social network: implications for tuberculosis elimination. Int J Tuberc Lung Dis 4 (2000) 1066-1073
46. Diel R., Meywald-Walter K., Gottschalk R., Rusch-Gerdes S., and Niemann S. Ongoing outbreak of tuberculosis in a low-incidence community: a molecular-epidemiological evaluation. Int J Tuberc Lung Dis 8 (2004) 855-861
47. Lemaitre N., Sougakoff W., Truffot-Pernot C., Cambau E., Derenne J.P., Bricaire F., et al. Use of DNA fingerprinting for primary surveillance of nosocomial tuberculosis in a large urban hospital: detection of outbreaks in homeless people and migrant workers. Int J Tuberc Lung Dis 2 (1998) 390-396
48. Tomes N. The making of a germ panic, then and now. Am J Public Health 90 (2000) 191-198
49. CDC. Trends in tuberculosis: USA 2004. MMWR 2005;54:245-49. Available from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5410a2.htm (accessed 3 May 2006).
50. Heath T., Roberts C., Winks M., and Capon A. The epidemiology of tuberculosis in New South Wales 1975-1995: the effects of immigration in a low prevalence population. Int J Tuberc Lung Dis 2 (1998) 647-654
51. Walker D., and Stevens W. The economics of TB control in developing countries. Expert Opin Pharmacother 4 (2003) 359-368
52. Schwartzman K., Oxlade O., Barr R.G., Grimard F., Acosta I., Baez J., et al. Domestic returns from investment in the control of tuberculosis in other countries. N Engl J Med 353 (2005) 1008-1020
53. Anonymous. Post-detention completion of tuberculosis treatment for persons deported or released from the custody of the Immigration and Naturalization Service: United States, 2003. MMWR Morb Mortal Wkly Rep 52 (2003) 438-441
54. Mitnick C., Furin J., Henry C., and Ross J. Tuberculosis among the foreign born in Massachusetts, 1982-1994: a reflection of social and economic disadvantage. Int J Tuberc Lung Dis 2 (1998) S32-S40
55. Houston H.R., Harada N., and Makinodan T. Development of a culturally sensitive educational intervention program to reduce the high incidence of tuberculosis among foreign-born Vietnamese. Ethn Health 7 (2002) 255-265
56. Hayward A.C., Darton T., Van-Tam J.N., Watson J.M., Coker R., and Schwoebel V. Epidemiology and control of tuberculosis in Western European cities. Int J Tuberc Lung Dis 7 (2003) 751-757
57. Anoymous. Increase in African immigrants and refugees with tuberculosis: Seattle, King County, Washington, 1998-2001. MMWR 51 (2002) 882-883
58. Espinal M.A., Laszlo A., Simonsen L., Boulahbal F., Kim S.J., Reniero A., et al. Global trends in resistance to antituberculosis drugs. N Engl J Med 344 (2001) 1294-1303
59. Willcox P.A. Drug resistant tuberculosis: worldwide trends, problems specific to Eastern Europe and other hotspots, and the threat to developing countries. Curr Opin Pulm Med 7 (2001) 148-153
60. Robert J., Trystram D., Truffot-Pernot C., and Jarlier V. Multidrug-resistant tuberculosis: eight years of surveillance in France. Eur Respir J 22 (2003) 833-837
61. El Sahly H.M., Adams G.J., Soini H., Teeter L., Musser J.M., and Graviss E.A. Epidemiologic differences between United States- and foreign-born tuberculosis patients in-Houston, Texas. J Infect Dis 183 (2001) 461-468
62. Zencovich M, Kennedy K, MacPherson DW, Gushulak BD. Immigration medical screening, migration and human immuno-deficiency virus infection. Int J STD AIDS, in press.
63. Pieterse S., and Ismail S. Nutritional risk factors for older refugees. Disasters 27 (2003) 16-36
64. Kwara A., Flanigan T.P., and Carter E.J. Highly active antiretroviral therapy (HAART) in adults with tuberculosis: current status. Int J Tuberc Lung Dis 9 (2005) 248-257
65. Sharma S.K., Mohan A., and Kadhiravan T. HIV-TB co-infection: epidemiology, diagnosis and management. Indian J Med Res 121 (2005) 550-567
66. Lewden C., Sobesky M., Cabie A., Couppie P., Boulard F., Bissuel F., et al. Groupe d'etude "Mortalite 2000". Causes of death among HIV infected adults in French Guyana and the French West Indies in the era of highly active antiretroviral therapy (HAART). Med Mal Infect 34 (2004) 286-292 [in French]
67. Seyler C, Toure S, Messou E, Bonard D, Gabillard D, Anglaret X. Risk factors for active tuberculosis following antiretroviral treatment initiation in Abidjan. Am J Respir Crit Care Med 2005; [Epub ahead of print] PMID: 15805184.
68. Limaye S., Quin J., and Steele R.H. HIV and tuberculosis co-infection in south-western Sydney: experience from a case series. Intern Med J 34 (2004) 203-206
69. Rieder H.L., Zellweger J.P., Raviglione M.C., Keizer S.T., and Migliori G.B. Tuberculosis control in Europe and international migration. Eur Respir J 7 (1994) 1545-1553
70. Coker J., Bell A., Pitman R., Hayward A., and Watson J. Screening programmes for tuberculosis in new entrants across Europe. Int J Tuberc Lung Dis 8 (2004) 1022-1026
71. Johnsen N.L., Steen T.W., Meyer H., Heldal E., Skarpaas I.J., and June G.B. Cohort analysis of asylum seekers in Oslo, Norway, 1987-1995: effectiveness of screening at entry and TB incidence in subsequent years. Int J Tuberc Lung Dis 9 (2005) 37-42
72. In: Floyd K. (Ed). Costs and effectiveness: the impact of economic studies on TB control. Tuberculosis (Edinb) 83 (2003) 187-200
73. Dahle U.R., Sandven P., Heldal E., and Caugant D.A. Continued low rates of transmission of Mycobacterium tuberculosis in Norway. J Clin Microbiol 41 (2003) 2968-2973
74. Department of Health. Stopping tuberculosis in England. An action plan from the Chief Medical Officer. London: Department of Health; October 2004.
75. Callister M.E., Barringer J., Thanabalasingam S.T., Gair R., and Davidson R.N. Pulmonary tuberculosis among political asylum seekers screened at Heathrow Airport, London, 1995-9. Thorax 57 (2002) 152-156
76. The Home Office. Controlling our borders. Making migration work for Britain. Five year strategy for asylum and immigration. London: The Home Office; February 2005. Available from http://www.official-documents.co.uk/document/cm64/6472/6472.htm (accessed 3 May 2006).
77. Coker R. Migration, public health and compulsory screening for TB and HIV. Asylum and Migration Working Paper 1. London: Institute for Public Policy Research; November 2003.
78. UKVisas. Health screening: general Q&A. December 24, 2005. Available from http://www.ukvisas.gov.uk/servlet/Front?pagename=OpenMarket/Xcelerate/ShowPage&c=Page&cid=1134650060850 (accessed 3 May 2006).
79. UKVisas. Health (tuberculosis) screening. December 24, 2005. Available from http://www.ukvisas.gov.uk/servlet/Front?pagename=OpenMarket/Xcelerate/ShowPage&c=Page&cid=1006977150250&a=KArticle&aid=1134650068984 (accessed 3 May 2006).
80. Khan K., Muennig P., Behta M., Pharm D., and Zivin J.G. Global drug-resistance patterns and the management of latent tuberculosis infection in immigrants to the United States. N Engl J Med 347 (2002) 1850-1859
81. CDC. Controlling tuberculosis in the United States: recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMWR 54 (2005) 1-81
82. Institute of Medicine, Committee on the Elimination of Tuberculosis in the United States. Ending neglect: the elimination of tuberculosis in the United States (2000), National Academy Press, Washington, DC
83. Menzies D. Screening immigrants to Canada for tuberculosis: chest radiography or tuberculin skin testing?. CMAJ 169 (2003) 1035-1036
84. Foundation for Innovative New Diagnostics. Request for applications: novel TB diagnostic methods: point-of-care detection of TB RFA-FIND/TDR-2005-01. Available from http://www.finddiagnostics.org/activities/tb_2005.htm (accessed 3 May 2006).
85. Rajalahti I., Ruokonen E.L., Kotomaki T., Sintonen H., and Nieminen M.M. Economic evaluation of the use of PCR assay in diagnosing pulmonary TB in a low-incidence area. Eur Respir J 23 (2004) 446-451
86. Albert H. Economic analysis of the diagnosis of smear-negative pulmonary tuberculosis in South Africa: incorporation of a new rapid test, FASTPlaqueTB, into the diagnostic algorithm. Int J Tuberc Lung Dis 8 (2004) 240-247
87. Okuda Y., Maekura R., Hirotani A., Kitada S., Yoshimura K., Hiraga T., et al. Rapid serodiagnosis of active pulmonary Mycobacterium tuberculosis by analysis of results from multiple antigen-specific tests. J Clin Microbiol 42 (2004) 1136-1141
88. Kivihya-Ndugga L.E., van Cleeff M.R., Githui W.A., Nganga L.W., Kibuga D.K., Odhiambo J.A., et al. A comprehensive comparison of Ziehl-Neelsen and fluorescence microscopy for the diagnosis of tuberculosis in a resource-poor urban setting. Int J Tuberc Lung Dis 7 (2003) 1163-1171
89. Wang J.Y., Lee L.N., Chou C.S., Huang C.Y., Wang S.K., Lai H.C., et al. Performance assessment of a nested-PCR assay (the RAPID BAP-MTB) and the BD ProbeTec ET system for detection of Mycobacterium tuberculosis in clinical specimens. J Clin Microbiol 42 (2004) 4599-4603
90. Harada N., Higuchi K., Sekiya Y., Rothel J., Kitoh T., and Mori T. Basic characteristics of a novel diagnostic method (QuantiFERON TB-2G) of latent tuberculosis infection with a use of Mycobacterium tuberculosis-specific antigens, ESAT-6 and CFP-10. Kekkaku 79 (2004) 725-735 [in Japanese]
91. ®-TB test for diagnosing latent Mycobacterium tuberculosis infection. MMWR 52 (2003) 15-18
92. DG News. FDA Approves QuantiFERON-TB GOLD for detection of immune responses to tuberculosis. Test could replace tuberculin skin test. Valencia, CA: December 3, 2004. Available from http://www.docguide.com/news/content.nsf/news/8525697700573E1885256F5F004F3B6F (accessed 3 May 2006).
93. Mazurek G.H., Jereb J., Lobue P., Iademarco M.F., Metchock B., and Vernon A. Division of tuberculosis elimination. National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC). Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States. MMWR Recomm Rep 54 (2005) 49-55
94. Horwitz O., Wilbek E., and Erickson P.A. Epidemiological basis of tuberculosis eradication: longitudinal studies on the risk of tuberculosis in the general population of a low-prevalence area. Bull World Health Organ 51 (1969) 95-113
95. Styblo K. Epidemiology of tuberculosis. Development of bacillary pulmonary tuberculosis capable of transmitting bacilli following infection with M. tuberculosis (the disease ratio). Selected Papers of the Royal Netherlands Tuberculosis Association, vol. 24, 1991. p. 55-66.
96. Uppaluri A., Naus M., Heywood N., Brunton J., Kerbel D., and Wobeser W. Effectiveness of the Immigration Medical Surveillance Program for tuberculosis in Ontario. Can J Public Health 93 (2002) 88-91
97. Ho M.J. Sociocultural aspects of tuberculosis: a literature review and a case study of immigrant tuberculosis. Soc Sci Med 59 (2004) 753-762
98. Coreil J., Lauzardo M., and Heurtelou M. Cultural feasibility assessment of tuberculosis prevention among persons of Haitian origin in South Florida. J Immigr Health 6 (2004) 63-69
99. Heywood N., Kawa B., Long R., Njoo H., Panaro L., and Wobeser W. Immigration subcommittee of the Canadian Tuberculosis Committee. Guidelines for the investigation and follow-up of individuals under medical surveillance for tuberculosis after arriving in Canada: a summary. CMAJ 168 (2003) 1563-1565
100. Pediatric Tuberculosis Collaborative Group. Targeted tuberculin skin testing and treatment of latent tuberculosis infection in children and adolescents. Pediatrics 114 (2004) 1175-1201
101. Diel R., Rusch-Gerdes S., and Niemann S. Molecular epidemiology of tuberculosis among immigrants in Hamburg, Germany. J Clin Microbiol 42 (2004) 2952-2960
102. Euro TB. Surveillance of tuberculosis in Europe. Available from http://www.eurotb.org/ (accessed 3 May 2006).
103. LoBue P.A., and Moser K.S. Screening of immigrants and refugees for pulmonary tuberculosis in San Diego County, California. Chest 126 (2004) 1777-1782
104. Schwartzman K. Latent tuberculosis infection: old problem, new priorities. CMAJ 166 (2002) 759-761
105. Enarson D.A. Tberculosis: 12. Global disease and the role of international collaboration. CMAJ 162 (2000) 57-61
106. Fanning A. The impact of global tuberculosis in Canada: we are our brothers' keepers. Can J Infect Dis 6 (1995) 225-226
107. Samaan G., Roche P., Spencer J., Bastian I., Christensen A., Hurwitz M., et al. National Tuberculosis Advisory Committee for the Communicable Diseases Network. Tuberculosis notifications in Australia, 2002. Commun Dis Intell 27 (2003) 449-458
108. Heywood N., Kawa B., Long R., Njoo H., Panaro L., and Wobeser W. Immigration Subcommittee of the Canadian Tuberculosis Committee. Guidelines for the investigation and follow-up of individuals under medical surveillance for tuberculosis after arriving in Canada: a summary. CMAJ 168 (2003) 1563-1565
109. Chemtob D., Leventhal A., and Weiler-Ravell D. Screening and management of tuberculosis in immigrants: the challenge beyond professional competence. Int J Tuberc Lung Dis 7 (2003) 959-966
110. Iademarco M.F., Sodt D., and Sutherland W.M. Evaluation and epidemiological research in tuberculosis control: linking medical care and public health. Mayo Clin Proc 79 (2004) 1110-1112
111. Okeke IN, Edelman R. Dissemination of antibiotic-resistant bacteria across geographic borders Clin Infec Dis 2001;33:364-69.
112. United Nations. Millennium development goals. Available from http://www.un.org/millenniumgoals/ (accessed 3 May 2006).
113. Statistics Canada. Canada's ethnocultural portrait: The changing mosaic. Available from url: http://www12.statcan.ca/english/census01/products/analytic/companion/etoimm/canada.cfm#majority_newest_immigrants_working_age (accessed 3 May 2006).