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Abstract
Introduction Improved 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 analysis This 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 dissemination Ethical 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.
- latent tuberculosis infection
- risk score
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Contributors JCJ and LAR are the primary study investigators. JCJ initiated the project and led on the design of the grant. JCJ and LAR led on the development of the protocol. JRC, RFB, DZR, KR, VJC and FM are investigators on the project who shared in the development of the protocol. All authors provided important intellectual content and gave their final approval of the version submitted for publication.
Funding This work is supported by the Michael Smith Foundation for Health Research. It is led by the BC Centre for Disease Control and the University of British Columbia. The partners in research are Population Data BC, BC PharmaNet, BC Cancer Agency and BC Renal Agency.
Disclaimer All inferences, opinions, and conclusions drawn in this protocol are those of the authors, and do not reflect the opinions or policies of the Data Steward(s).
Competing interests None declared.
Ethics approval University of British Columbia Clinical Research Ethics Review Board (H13-03216).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement These data are held by Population Data BC, housed at the University of British Columbia. All data to be used in this study are available to researchers through a data access request to Population Data BC.