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Acceptance and safety of directly observed versus self-administered isoniazid preventive therapy in aboriginal peoples in British Columbia.

https://arctichealth.org/en/permalink/ahliterature203522
Source
Int J Tuberc Lung Dis. 1998 Dec;2(12):979-83
Publication Type
Article
Date
Dec-1998
Author
G. Heal
R K Elwood
J M FitzGerald
Author Affiliation
BC Centre for Disease Control Society, Ministry of Health and Respiratory Medicine, University of British Columbia, Vancouver, Canada.
Source
Int J Tuberc Lung Dis. 1998 Dec;2(12):979-83
Date
Dec-1998
Language
English
Publication Type
Article
Keywords
Adult
Antitubercular Agents - administration & dosage
British Columbia
Female
Humans
Indians, North American
Isoniazid - administration & dosage
Male
Middle Aged
Patient Acceptance of Health Care
Retrospective Studies
Self Administration
Tuberculosis, Pulmonary - prevention & control
Abstract
To document experience with directly observed chemoprophylaxis (DOPT) compared to self-administered isoniazid (INH) among aboriginal persons in British Columbia.
DOPT was compared to self-administered delivery (SAD) over a 3-year period. All aboriginal persons who received INH chemoprophylaxis in British Columbia between 1992 and 1994 were evaluated. Therapy completion rates and adverse outcomes associated with SAD were compared with DOPT. Treatment allocation was by patient choice.
Of 608 people who received INH prophylaxis, 443 received SAD (mean age 31.6 years) and 165 received DOPT (mean age 23.9 years). Two hundred and seventy (60.9%) SAD compared to 124 (75.2%) in the DOPT group completed 6 months of INH (P = 0.0011). The 12-month completion rates were 162/443 (36.6%) for the SAD group and 84/165 (50.9%) for the DOPT group (P = 0.0014). Adverse reactions requiring discontinuation of medication occurred in 13.5% of the patients on SAD and 9.7% of those receiving DOPT (P = 0.202). The most common reason cited for failure to complete therapy was non-cooperation in both groups. There were three deaths in the SAD group, one of which was due to suicide by self-ingestion of INH.
These data demonstrate that in aboriginal people compliance with preventive therapy can be improved by DOPT. Non random allocation to treatment groups might have influenced our findings, and further prospective randomized trials and cost-effectiveness analyses are required.
PubMed ID
9869112 View in PubMed
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BCG vaccination and the prevalence of latent tuberculosis infection in an aboriginal population.

https://arctichealth.org/en/permalink/ahliterature166082
Source
Int J Tuberc Lung Dis. 2006 Dec;10(12):1347-53
Publication Type
Article
Date
Dec-2006
Author
V J Cook
L. Kuramoto
K. Noertjojo
R K Elwood
J M Fitzgerald
Author Affiliation
Department of Tuberculosis Control, British Columbia Centre for Disease Control (BCCDC), Vancouver, Canada. victoria.cook@bccdc.ca
Source
Int J Tuberc Lung Dis. 2006 Dec;10(12):1347-53
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
BCG Vaccine - therapeutic use
British Columbia - epidemiology
Child
Female
Humans
Male
Middle Aged
Population
Prevalence
Retrospective Studies
Tuberculin Test
Tuberculosis, Pulmonary - epidemiology - prevention & control
Vaccination
Abstract
Estimations of prevalence of latent tuberculous infection (LTBI) are confounded by factors known to influence the results of the tuberculin skin test (TST) such as age, contact history and bacille Calmette-Guerin (BCG) vaccination. Appropriate interpretation of TST results is necessary to ensure LTBI treatment for those at greatest risk.
To document the prevalence of LTBI in Aboriginal people living on a reserve in British Columbia (BC) and to determine the influence of BCG.
A population-based, retrospective descriptive analysis of all epidemiological data collected for the on-reserve Aboriginal programme in BC (1951-1996).
Of 17615 persons who received a TST during the study period, 42% had received BCG. During the study period, an average of 2517 TSTs were completed per year (SD = 1228) among persons with an average age of 26 years (SD = 16). Among all subjects, the average prevalence of LTBI was 25% (95 %CI 24-25). The presence of BCG (OR = 3.1, 95%CI 2.8-3.4) and multiple BCGs (OR = 10.2, 95%CI 7.7-13.6) were both associated with a positive TST. A positive TST was also associated with a shorter duration in years between the most recent BCG and the TST.
The average prevalence of LTBI in a sequential sample of Aboriginal people living on a reserve in BC was estimated at 25%. BCG, especially in multiple doses, increased the likelihood of a positive TST.
PubMed ID
17167951 View in PubMed
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Clinical features of abdominal tuberculosis.

https://arctichealth.org/en/permalink/ahliterature232410
Source
J Infect Dis. 1988 Oct;158(4):687-92
Publication Type
Article
Date
Oct-1988
Author
A. Jakubowski
R K Elwood
D A Enarson
Author Affiliation
Division of Tuberculosis Control, British Columbia Ministry of Health, Vancouver, Canada.
Source
J Infect Dis. 1988 Oct;158(4):687-92
Date
Oct-1988
Language
English
Publication Type
Article
Keywords
Adult
Alcoholism - complications
Anal Canal
Asia - ethnology
Asian Continental Ancestry Group
Canada
Cecum
Diagnosis, Differential
Female
Humans
Ileum
Indians, North American
Male
Mesentery
Middle Aged
Peritonitis, Tuberculous - epidemiology - ethnology
Rectum
Retrospective Studies
Sex Factors
Tuberculosis, Gastrointestinal - epidemiology - ethnology
Tuberculosis, Lymph Node - epidemiology - ethnology
Abstract
The clinical features of 81 cases of abdominal tuberculosis (TB) are presented. The peritoneum was involved in 41 patients, the ileocecal area in 17, the anorectal area in 16, and mesenteric glands in 8. There was one case each involving the liver and sigmoid colon. Most patients were young women. The tuberculin reaction was significant in 83% of patients tested, and 54% had evidence of TB elsewhere. Tuberculous peritonitis was more common in native North American Indians and presented as an acute abdomen, abdominal tumor, or cirrhosis. Asians developed the majority of ileocecal and mesenteric lymph node disease and were frequently diagnosed as having Crohn's disease, appendicitis, or cancer. Anorectal cases presented with fistulae or abscesses and usually had concomitant pulmonary TB. The disease was fatal in five patients (6%), four of whom were diagnosed only after death. One noncompliant patient had a relapse. All other patients were cured after receiving treatment.
Notes
Comment In: J Infect Dis. 1989 Aug;160(2):344-52760489
PubMed ID
3171223 View in PubMed
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Cost-effectiveness of a new interferon-based blood assay, QuantiFERON-TB Gold, in screening tuberculosis contacts.

https://arctichealth.org/en/permalink/ahliterature154157
Source
Int J Tuberc Lung Dis. 2008 Dec;12(12):1414-24
Publication Type
Article
Date
Dec-2008
Author
F. Marra
C A Marra
M. Sadatsafavi
O. Morán-Mendoza
V. Cook
R K Elwood
M. Morshed
R C Brunham
J M Fitzgerald
Author Affiliation
University of British Columbia, Vancouver, British Columbia, Canada. carlo.marra@ubc.ca
Source
Int J Tuberc Lung Dis. 2008 Dec;12(12):1414-24
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
BCG Vaccine
Canada
Clinical Laboratory Techniques - economics
Contact Tracing
Cost-Benefit Analysis
Humans
Interferon-gamma - blood
Markov Chains
Middle Aged
Sensitivity and specificity
Tuberculin Test - economics
Tuberculosis - diagnosis
Vaccination
Abstract
Recent approval of interferon-gamma release assays that are more specific for Mycobacterium tuberculosis has given new options for the diagnosis of latent tuberculosis infection (LTBI).
To assess the cost-effectiveness of Quanti-FERON-TB Gold (QFT-G) vs. the tuberculin skin test (TST) in diagnosing LTBI in contacts of active TB cases using a decision analytic Markov model.
Three screening strategies--TST alone, QFT-G alone and sequential screening of TST then QFT-G--were evaluated. The model was further stratified according to ethnicity and bacille Calmette-Guérin (BCG) vaccination status. Data sources included published studies and empirical data. Results were reported in terms of the incremental net monetary benefit (INMB) of each strategy compared with the baseline strategy of TST-based screening in all contacts.
The most economically attractive strategy was to administer QFT-G in BCG-vaccinated contacts, and to reserve TST for all others (INMB CA$3.70/contact). The least cost-effective strategy was QFT-G for all contacts, which resulted in an INMB of CA$-11.50 per contact. Assuming a higher prevalence of recent infection, faster conversion of QFT-G, a higher rate of TB reactivation, reduction in utility or greater adherence to preventive treatment resulted in QFT-G becoming cost-effective in more subgroups.
Selected use of QFT-G appears to be cost-effective if used in a targeted fashion.
PubMed ID
19017451 View in PubMed
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Demographic risk factors of pulmonary colonization by non-tuberculous mycobacteria.

https://arctichealth.org/en/permalink/ahliterature146747
Source
Int J Tuberc Lung Dis. 2010 Jan;14(1):106-12
Publication Type
Article
Date
Jan-2010
Author
E. Hernández-Garduño
R K Elwood
Author Affiliation
Division of TB Control, British Columbia Centre for Disease Control and Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. eduardo.hernandez@bccdc.ca
Source
Int J Tuberc Lung Dis. 2010 Jan;14(1):106-12
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
British Columbia - epidemiology
Child
Child, Preschool
Continental Population Groups - ethnology
Databases, Factual
Female
Humans
Indians, North American
Infant
Male
Middle Aged
Mycobacterium Infections, Nontuberculous - epidemiology - ethnology - microbiology
Mycobacterium avium Complex - isolation & purification
Mycobacterium avium-intracellulare Infection - epidemiology - ethnology - microbiology
Nontuberculous Mycobacteria - isolation & purification
Retrospective Studies
Risk factors
Sex Factors
Time Factors
Young Adult
Abstract
British Columbia (BC), Canada.
To determine the risk factors for pulmonary colonization by non-tuberculous mycobacteria (NTM).
Retrospective study of subjects colonized by NTM from 1990 to 2006. Subjects without mycobacterial disease and with at least three negative cultures served as controls.
Mycobacterium avium complex (MAC) species were the most common NTM. Risk factors of colonization included age > or = 60 years (aOR 2.3), female sex (aOR 1.2), residency in Canada for at least 10 years (aOR 3.8), Canadian-born aboriginal (aOR 1.8), and Canadian-born non-aboriginal (aOR 1.4). Predictors of MAC colonization included White race (aOR 1.6) and residency in Canada for at least 10 years, which was the strongest predictor (aOR 6.7). Aboriginal origin was associated with non-MAC colonization (aOR 1.8), and Canadian-born people from the East/South-East Asian ethnic groups were protected from MAC colonization (aOR 0.2), all aOR P
PubMed ID
20003703 View in PubMed
Less detail
Source
CMAJ. 1999 Sep 7;161(5):489
Publication Type
Article
Date
Sep-7-1999
Author
J M FitzGerald
R K Elwood
S. Chia
Source
CMAJ. 1999 Sep 7;161(5):489
Date
Sep-7-1999
Language
English
Publication Type
Article
Keywords
British Columbia - epidemiology
Comorbidity
Humans
Incidence
Kidney Failure, Chronic - complications
Renal Dialysis
Risk assessment
Tuberculosis - epidemiology
Notes
Comment On: CMAJ. 1999 Jun 1;160(11):1557-6310373996
PubMed ID
10497603 View in PubMed
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Evidence for TB clustering in Vancouver: results from pilot study using RFLP fingerprinting.

https://arctichealth.org/en/permalink/ahliterature212189
Source
Can Commun Dis Rep. 1996 Apr 1;22(7):49-51
Publication Type
Article
Date
Apr-1-1996

HIV-related tuberculosis in British Columbia: indications of a rise in prevalence and a change in risk groups.

https://arctichealth.org/en/permalink/ahliterature211383
Source
Clin Invest Med. 1996 Aug;19(4):271-8
Publication Type
Article
Date
Aug-1996
Author
M F Blenkush
M. Korzeniewska-Kozela
R K Elwood
W. Black
J M FitzGerald
Author Affiliation
Department of Medicine, University of British Columbia, Vancouver.
Source
Clin Invest Med. 1996 Aug;19(4):271-8
Date
Aug-1996
Language
English
Publication Type
Article
Keywords
AIDS-Related Opportunistic Infections - drug therapy - epidemiology - microbiology
Adult
Aged
British Columbia - epidemiology
Epidemiology - trends
Female
HIV Infections - chemically induced - drug therapy - epidemiology
Humans
Male
Middle Aged
Prevalence
Risk factors
Risk-Taking
Sex Factors
Tuberculosis, Pulmonary - drug therapy - epidemiology - microbiology
Abstract
To identify patients with coexisting HIV infection and tuberculosis (TB) and recent trends in prevalence and factors associated with coinfection.
Case review.
All known patients with TB and HIV infection in British Columbia, in whom TB was diagnosed between 1990 and 1994. This group was compared with those in whom TB was diagnosed between 1984 and 1990.
Patients' demographic characteristics and risk factors for HIV infection, site of TB, occurrence of drug-resistant TB, treatment and outcome.
Forty-four patients with HIV infection and TB were identified, of whom 16% were women, whereas non of those diagnosed from 1984 to 1990 were women, and 14 (32%) were aboriginal Canadians, compared with only 3 (8%) of those diagnosed from 1984 to 1990 (p
PubMed ID
8853575 View in PubMed
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Impact of country of origin on drug-resistant tuberculosis among foreign-born persons in British Columbia.

https://arctichealth.org/en/permalink/ahliterature167966
Source
Int J Tuberc Lung Dis. 2006 Aug;10(8):844-50
Publication Type
Article
Date
Aug-2006
Author
A. Moniruzzaman
R K Elwood
M. Schulzer
J M FitzGerald
Author Affiliation
Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada. akmubc@yahoo.com
Source
Int J Tuberc Lung Dis. 2006 Aug;10(8):844-50
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Analysis of Variance
Anti-Bacterial Agents - therapeutic use
Antibiotics, Antitubercular - therapeutic use
British Columbia - epidemiology
Child
Child, Preschool
Drug Resistance, Multiple, Bacterial - drug effects - ethnology
Emigration and Immigration
Ethambutol - therapeutic use
Female
Humans
Infant
Infant, Newborn
Isoniazid - therapeutic use
Logistic Models
Male
Microbial Sensitivity Tests
Middle Aged
Mycobacterium tuberculosis - drug effects
Odds Ratio
Pyrazinamide - therapeutic use
Rifampin - therapeutic use
Risk factors
Streptomycin - therapeutic use
Tuberculosis, Multidrug-Resistant - drug therapy - epidemiology - ethnology - microbiology
Tuberculosis, Pulmonary - drug therapy - epidemiology - ethnology - microbiology
Abstract
Provincial tuberculosis (TB) services, British Columbia, Canada.
To estimate the risk of drug resistance among foreign-born TB patients and to identify risk factors associated with drug resistance.
Using the provincial TB database, we examined all culture-positive foreign-born TB patients for the years 1990-2001. The risk of having a drug-resistant isolate was estimated according to country and region of origin.
Of 1940 foreign-born patients identified, 247 (12.7%, 95%CI 11.3-14.3) cases had isolates resistant to at least one of the first-line drugs, with 160 (8.3%) isolates showing monoresistance, 24 (1.2%) multidrug resistance (resistance to at least isoniazid and rifampin) and 63 (3.3%) polyresistance (resistance to two or more drugs, excluding MDR). Country-specific analysis showed that immigrants from Vietnam (adjusted OR 2.12, 95%CI 1.37-3.27) and the Philippines (adjusted OR 1.71, 95%CI 1.10-2.66) had a significantly higher risk of resistance than other immigrants. In addition, the risk was the highest for younger TB patients and patients with reactivated disease (adjusted OR 2.12, 95%CI 1.09-4.09).
The risk of drug resistance was the highest among foreign-born patients from Vietnam and the Philippines. These findings should assist clinicians in prescribing and tailoring anti-tuberculosis regimens for immigrants more appropriately.
PubMed ID
16898367 View in PubMed
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21 records – page 1 of 3.