Knowledge and Perceptions of Latent Tuberculosis Infection among Chinese Immigrants in a Canadian Urban Centre

Gao, Jie; Berry, Nicole S.; Taylor, David; Venners, Scott A.; Cook, Victoria; Mayhew, Maureen

doi:10.1155/2015/546042

Cited by 33 publications

(59 citation statements)

References 16 publications

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“…Most of the research studies focused on migrant communities, 53 including communities from broadly Spanish-speaking South American and Caribbean countries, [54][55][56][57] Sub-Saharan African refugees, 52 migrants or refugees from Somalia or Ethiopia, [58][59][60] Chinese migrants, 61 African communities/migrants, 62 homeless populations, 57,63,64 migrant and refugee learners, 65 and a mixed population of migrants; 66,67 one study was performed in an indigenous community -the Inuit. 68 Only one study surveyed the views of the general population in the USA.…”

Section: What Type Of Community Was the Focus Of The Research?mentioning

confidence: 99%

Tuberculosis stigma as a social determinant of health: a systematic mapping review of research in low incidence countries

Craig

Daftary

Engel

et al. 2017

International Journal of Infectious Diseases

182

134

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Tuberculosis (TB)-related stigma is an important social determinant of health. Research generally highlights how stigma can have a considerable impact on individuals and communities, including delays in seeking health care and adherence to treatment. There is scant research into the assessment of TB-related stigma in low incidence countries. This study aimed to systematically map out the research into stigma. A particular emphasis was placed on the methods employed to measure stigma, the conceptual frameworks used to understand stigma, and whether structural factors were theorized. Twenty-two studies were identified; the majority adopted a qualitative approach and aimed to assess knowledge, attitudes, and beliefs about TB. Few studies included stigma as a substantive topic. Only one study aimed to reduce stigma. A number of studies suggested that TB control measures and representations of migrants in the media reporting of TB were implicated in the production of stigma. The paucity of conceptual models and theories about how the social and structural determinants intersect with stigma was apparent. Future interventions to reduce stigma, and measurements of effectiveness, would benefit from a stronger theoretical underpinning in relation to TB stigma and the intersection between the social and structural determinants of health.

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Section: What Type Of Community Was the Focus Of The Research?mentioning

confidence: 99%

Tuberculosis stigma as a social determinant of health: a systematic mapping review of research in low incidence countries

Craig

Daftary

Engel

et al. 2017

International Journal of Infectious Diseases

182

134

View full text Add to dashboard Cite

show abstract

“…(11,12) However, we lack insights in the burden of LTBI related stigma among target groups for TB prevention activities in low TB incidence countries. (14,15) Scambler (2009) de ned stigma as "a social process, experienced or anticipated, characterized by exclusion, rejection, blame or devaluation that results from experience, perception or reasonable anticipation of an adverse social judgement about a person or a group." (16) Stigma can be classi ed in three categories (14,17): (1) enacted stigma, in which a person experiences exclusion and/or discrimination.…”

Section: Introductionmentioning

confidence: 99%

“…For example, Chinese immigrants in Canada believed that society would exclude those with an LTBI diagnosis. (15) Out of fear of exclusion, they would conceal their LTBI diagnosis and treatment to people in their social network. Besides suffering of the individual, stigma can also negatively affect public health: fear of TB and related stigma can cause diagnostic and treatment delays, as persons would rather hide their symptoms than seek care, leading to a continuous risk of TB transmission, more severe morbidity, and poorer treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes, beliefs, and stigma related to latent tuberculosis infection: a qualitative study among Eritreans in the Netherlands

Spruijt¹,

Haile²,

Hof

et al. 2020

Preprint

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Background: Tailored and culturally appropriate latent tuberculosis (TB) infection screening and treatment programs, including interventions against TB stigma, are needed to reduce TB incidence in low TB incidence countries. However, we lack insights in stigma related to latent TB infection (LTBI) among target groups, such as asylum seekers and refugees. We therefore studied knowledge, attitudes, beliefs and stigma associated with LTBI among Eritrean asylum seekers and refugees in the Netherlands.Methods: We used convenience sampling to interview adult Eritrean asylum seekers and refugees: 26 semi-structured group interviews following TB and LTBI related health education and LTBI screening, and 31 semi-structured individual interviews with Eritreans during or after completion of LTBI treatment (November 2016-May 2018). We used a thematic analysis to identify, analyse and report patterns in the data.Results: Despite TB/LTBI education, misconceptions embedded in cultural beliefs about TB transmission and prevention persisted. Fear of getting infected with TB was the cause of reported enacted (isolation and gossip) and anticipated (concealment of treatment and self-isolation) stigma by participants on LTBI treatment. Conclusion: The inability to differentiate LTBI from TB disease and consequent fear of getting infected by persons with LTBI led to enacted and anticipated stigma comparable to stigma related to TB disease among Eritreans. Additional to continuous culturally sensitive education activities, TB prevention programs should implement evidence-based interventions reducing stigma at all phases in the LTBI screening and treatment cascade.

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“…This leads to a large burden of unnecessary LTBI treatment, with associated risks of drug toxicity to patients, and economic costs to health services. Furthermore, poor predictive value may also undermine the uptake of LTBI treatment among target groups because of the low perceived risk of TB (7). The WHO has therefore highlighted the development of novel biomarkers with better predictive value as a key research and development priority in a target product profile (TPP) consensus document, stating optimal performance criteria of sensitivity and specificity >90% over a 2-year interval (8).…”

mentioning

confidence: 99%

Quantitative IFN-γ Release Assay and Tuberculin Skin Test Results to Predict Incident Tuberculosis. A Prospective Cohort Study

Rk¹,

Lipman

Jackson³

et al. 2020

Am J Respir Crit Care Med

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Rationale: Development of diagnostic tools with improved predictive value for tuberculosis (TB) is a global research priority. Objectives: We evaluated whether implementing higher diagnostic thresholds than currently recommended for QuantiFERON Gold-in-Tube (QFT-GIT), T-SPOT.TB, and the tuberculin skin test (TST) might improve prediction of incident TB. Methods: Follow-up of a UK cohort of 9,610 adult TB contacts and recent migrants was extended by relinkage to national TB surveillance records (median follow-up 4.7 yr). Incidence rates and rate ratios, sensitivities, specificities, and predictive values for incident TB were calculated according to ordinal strata for quantitative results of QFT-GIT, T-SPOT.TB, and TST (with adjustment for prior bacillus Calmette-Guérin [BCG] vaccination). Measurements and Main Results: For all tests, incidence rates and rate ratios increased with the magnitude of the test result (P , 0.0001). Over 3 years' follow-up, there was a modest increase in positive predictive value with the higher thresholds (3.0% for QFT-GIT >0.35 IU/ml vs. 3.6% for >4.00 IU/ml; 3.4% for T-SPOT.TB >5 spots vs. 5.0% for >50 spots; and 3.1% for BCG-adjusted TST >5 mm vs. 4.3% for >15 mm). As thresholds increased, sensitivity to detect incident TB waned for all tests (61.0% for QFT-GIT >0.35 IU/ml vs. 23.2% for >4.00 IU/ml; 65.4% for T-SPOT.TB >5 spots vs. 27.2% for >50 spots; 69.7% for BCG-adjusted TST >5 mm vs. 28.1% for >15 mm). Conclusions: Implementation of higher thresholds for QFT-GIT, T-SPOT.TB, and TST modestly increases positive predictive value for incident TB, but markedly reduces sensitivity. Novel biomarkers or validated multivariable risk algorithms are required to improve prediction of incident TB.

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Knowledge and Perceptions of Latent Tuberculosis Infection among Chinese Immigrants in a Canadian Urban Centre

Cited by 33 publications

References 16 publications

Tuberculosis stigma as a social determinant of health: a systematic mapping review of research in low incidence countries

Tuberculosis stigma as a social determinant of health: a systematic mapping review of research in low incidence countries

Knowledge, attitudes, beliefs, and stigma related to latent tuberculosis infection: a qualitative study among Eritreans in the Netherlands

Quantitative IFN-γ Release Assay and Tuberculin Skin Test Results to Predict Incident Tuberculosis. A Prospective Cohort Study

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