Improving health system efficiency in tuberculosis prevention and control through targeted LTBI screening in the foreign-born

Project number: 
Approval date: 
Wednesday, April 1, 2015
Principal Investigator: 
BC Centre for Disease Control (BCCDC)
Funding Agency: 
Canadian Institutes of Health Research(CIHR),Michael Smith Foundation (MSFHR),BC Centre for Disease
Datasets requested: 
Deaths (BC Vital Statistics Agency)
Medical Services Plan (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
Citizenship and Immigration Canada (CIC) Permanent Residents
Hospital Separations (BC Ministry of Health)
Consolidation registry (Ministry of Health)
BC Centre for Disease Control
Income band (Statistics Canada)
bc cancer
consolidation - census geocodes
Research objective: 


We hypothesize that certain subgroups within foreign-born populations are at higher risk for TB and can be identified based on demographic and medical risk factors.

1. Overall goal
This proposal focuses on the development and implementation of targeted, evidence-based, and cost-effective latent tuberculosis infection (LTBI) screening recommendations for the foreign-born population of BC. The evidence generated by this study will allow us to evaluate current screening guidelines and will guide decisions on the implementation of population based foreign-born LTBI screening programs across Canada.

2. Study objectives
The objectives of this study are threefold:
i. To identify specific subgroups of the foreign-born population that are at high-risk for active TB based on demographic and medical risk factors. This will include the development of a TB risk score that will quantify an individuals risk of active TB depending on demographic and medical risk factors.
ii. To determine which high-risk populations would be most cost-effective to screen and treat for LTBI from a health systems perspective (Phase 2).
iii. To implement the most cost-effective strategies across the province through a network of stakeholders, physicians and community groups by leveraging an established provincial TB strategic implementation group (Phase 3).


Journal Publication

  • Ronald LA, Campbell JR, Balshaw RF, Roth DZ, Romanowski K, Marra F, Cook VJ, Johnston JC. Predicting tuberculosis risk in the foreign-born population of British Columbia, Canada: study protocol for a retrospective population-based cohort study. BMJ Open. 2016 Nov 25;6(11):e013488

Presentation of research material (poster/seminar/lecture etc.)

  • Ronald LA, Johnston J. Tuberculosis in the foreign-born population of British Columbia. BC Centre for Disease Control Grand Rounds. December 13th, 2016. Vancouver, BC

Page last revised: December 5, 2017