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Post-tuberculosis mortality risk among immigrants to British Columbia, Canada, 1985–2015: a time-dependent Cox regression analysis of linked immigration, public health, and vital statistics data

Canadian journal of public health, 2021-02, Vol.112 (1), p.132-141 [Peer Reviewed Journal]

The Canadian Public Health Association 2020 ;The Canadian Public Health Association 2020. ;ISSN: 0008-4263 ;EISSN: 1920-7476 ;DOI: 10.17269/s41997-020-00345-y ;PMID: 32666352

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  • Title:
    Post-tuberculosis mortality risk among immigrants to British Columbia, Canada, 1985–2015: a time-dependent Cox regression analysis of linked immigration, public health, and vital statistics data
  • Author: Basham, C. Andrew ; Karim, Mohammad Ehsanul ; Cook, Victoria J. ; Patrick, David M. ; Johnston, James C.
  • Subjects: Cancer ; Cardiovascular diseases ; Cohort analysis ; Diagnosis ; Immigrants ; Immigration ; Injuries ; Medicine ; Medicine & Public Health ; Mortality ; Mortality risk ; Noncitizens ; Public Health ; Quantitative Research ; Regression analysis ; Respiratory diseases ; Risk ; Statistical analysis ; Time dependence ; Tuberculosis ; Vital statistics
  • Is Part Of: Canadian journal of public health, 2021-02, Vol.112 (1), p.132-141
  • Description: Objective To compare non-tuberculosis (non-TB)-cause mortality risk overall and cause-specific mortality risks within the immigrant population of British Columbia (BC) with and without TB diagnosis through time-dependent Cox regressions. Methods All people immigrating to BC during 1985–2015 ( N  = 1,030,873) were included with n  = 2435 TB patients, and the remaining as non-TB controls. Outcomes were time-to-mortality for all non-TB causes, respiratory diseases, cardiovascular diseases, cancers, and injuries/poisonings, and were ascertained using ICD-coded vital statistics data. Cox regressions were used, with a time-varying exposure variable for TB diagnosis. Results The non-TB-cause mortality hazard ratio (HR) was 4.01 (95% CI 3.57–4.51) with covariate-adjusted HR of 1.69 (95% CI 1.50–1.91). Cause-specific covariate-adjusted mortality risk was elevated for respiratory diseases (aHR = 2.96; 95% CI 2.18–4.00), cardiovascular diseases (aHR = 1.63; 95% CI 1.32–2.02), cancers (aHR = 1.40; 95% CI 1.13–1.75), and injuries/poisonings (aHR = 1.85; 95% CI 1.25–2.72). Conclusions In any given year, if an immigrant to BC was diagnosed with TB, their risk of non-TB mortality was 69% higher than if they were not diagnosed with TB. Healthcare providers should consider multiple potential threats to the long-term health of TB patients during and after TB treatment. TB guidelines in high-income settings should address TB survivor health.
  • Publisher: Cham: Springer International Publishing
  • Language: English
  • Identifier: ISSN: 0008-4263
    EISSN: 1920-7476
    DOI: 10.17269/s41997-020-00345-y
    PMID: 32666352
  • Source: PubMed Central
    ProQuest Central
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