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Guidelines

Evidence-based clinical guidelines for immigrants and refugees

Kevin Pottie, Christina Greenaway, John Feightner, Vivian Welch, Helena Swinkels, Meb Rashid, Lavanya Narasiah, Laurence J. Kirmayer, Erin Ueffing, Noni E. MacDonald, Ghayda Hassan, Mary McNally, Kamran Khan, Ralf Buhrmann, Sheila Dunn, Arunmozhi Dominic, Anne E. McCarthy, Anita J. Gagnon, Cécile Rousseau, Peter Tugwell and coauthors of the Canadian Collaboration for Immigrant and Refugee Health
CMAJ September 06, 2011 183 (12) E824-E925; DOI: https://doi.org/10.1503/cmaj.090313
Kevin Pottie
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  • For correspondence: kpottie@uottawa.ca
Christina Greenaway
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John Feightner
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Vivian Welch
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Helena Swinkels
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Meb Rashid
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Lavanya Narasiah
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Laurence J. Kirmayer
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Erin Ueffing
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Noni E. MacDonald
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Ghayda Hassan
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Mary McNally
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Kamran Khan
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Ralf Buhrmann
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Sheila Dunn
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Arunmozhi Dominic
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Anne E. McCarthy
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Anita J. Gagnon
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Cécile Rousseau
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Peter Tugwell
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Figures

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  • Figure 2A:
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    Figure 2A:

    Participant sampling and response rate. *One person was on sabbatical, three were on a leave of absence and one cited workload. Adapted, with permission, from Swinkels and associates.15

  • Figure 3A:
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    Figure 3A:

    Sample logic model for HIV (adapted from US Preventive Services Task Force).88 Open rectangles designate the potential screening population and patient factors to be considered; shaded rectangles designate interventions and related outcomes; and circles and numbers provide points in the evidence chain that were used to develop the search questions. Note: ARV = antiretroviral, EIA = enzyme immunoassay.

  • Figure 9A:
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    Figure 9A:

    Estimated worldwide prevalence of hepatitis C, 1999. Based on data from the World Health Organization.284

  • Figure 10A:
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    Figure 10A:

    Number of immigrants and refugees screened for strongyloidiasis by birth country, as identified in our review of the medical literature between 1988 and 2010.

  • Figure 11A:
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    Figure 11A:

    Map of migrant source countries with overlay of malaria endemicity. Based on data from the 2006 Census of Canada100 and the World Health Organization.348

Tables

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    Table 1A:

    Classification of international migration to Canada (2007)*

    Table 1A:
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    Table 1B:

    Basis of recommendations*

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    Table 2A:

    Demographic characteristics of 40 participants in Delphi consensus process*

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    Box 4A:

    Recommendations from the Canadian Collaboration for Immigrant and Refugee Health: vaccine-preventable diseases

    Box 4A:
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    Table 4A:

    Summary of findings for vaccination to prevent rubella and tetanus

    Table 4A:
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    Table 5A:

    Summary of findings for vaccination to prevent varicella and related morbidity and mortality

    Table 5A:
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    Box 6A:

    Recommendations from the Canadian Collaboration for Immigrant and Refugee Health: hepatitis B virus

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    Table 6A:

    Global patterns of chronic infection with hepatitis B virus (HBV) and hepatocellular carcinoma

    Table 6A:
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    Table 6B:

    Summary of findings for efficacy of lamivudine to decrease mortality in patients with chronic HBV infection

    Table 6B:
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    Table 6C:

    Summary of findings for efficacy of universal childhood vaccination to decrease chronic HBV infection

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    Table 7A:

    Relative risk (RR) that active tuberculosis will develop in the presence of underlying medical conditions*

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    Table 7B:

    Summary of findings for isoniazid to prevent active tuberculosis

    Table 7B:
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    Table 7C:

    Summary of findings for use of isoniazid for all age groups with latent tuberculosis infection

    Table 7C:
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    Table 7D:

    Estimated numbers needed to treat for latent tuberculosis infection to prevent one case of active tuberculosis by age, time since arrival and adherence*

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    Table 8A:

    Prevalence of HIV by region in 2007*

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    Table 8B:

    Summary of findings on how pretest counselling and screening affect high-risk behaviours

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    Table 8C:

    Summary of findings for antiretroviral treatment of HIV/AIDS

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    Table 9A:

    Summary of findings for comparison of pegylated interferon plus ribavirin compared with interferon plus ribavirin for treatment of chronic hepatitis C virus infection

    Table 9A:
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    Box 10A:

    Recommendations from the Canadian Collaboration for Immigrant and Refugee Health: intestinal parasites

    Box 10A:
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    Table 10A:

    Summary of findings for comparison of ivermectin and pyrvinium pamoate for strongyloidiasis

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    Table 10B:

    Summary of findings for comparison of praziquantel and placebo for treatment of schistosomiasis

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    Table 12A:

    Summary of findings for effects of collaborative care for depression

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    Box 14A:

    Recommendations from the Canadian Collaboration for Immigrant and Refugee Health: child maltreatment

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    Table 14A:

    Summary of findings for home visitation by nurses to prevent child maltreatment

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    Table 14B:

    Summary of findings for cognitive–behavioural therapy for sexually abused children

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    Table 15A:

    Summary of findings on screening for intimate partner violence to reduce morbidity due to such violence

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    Table 15B:

    Summary of findings for advocacy programs to prevent further intimate partner violence

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    Table 16A:

    Country-and ethnic-specific values for waist circumference518,519

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    Table 16B:

    Summary of findings for lifestyle modifications to prevent type 2 diabetes mellitus

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    Table 16C:

    Summary of findings for intensive antihypertensive treatment in patients with type 2 diabetes mellitus to prevent cardiovascular disease

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    Table 17A:

    Anemia prevalence and number of people affected among preschool-age children and nonpregnant women in each World Health Organization (WHO) region*

    Table 17A:
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    Table 17B:

    Summary of findings for iron supplements to treat iron deficiency in children

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    Table 17C:

    Summary of findings for iron supplements compared with placebo for women of reproductive age

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    Table 18A:

    Summary of findings for use of sealant to prevent carious lesions

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    Table 18B:

    Summary of findings for use of NSAIDS as treatment for pain and swelling of dental origin

    Table 18B:
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    Table 19A:

    Summary of findings for vision screening and correction to reduce visual impairment

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    Table 20A:

    Summary of findings for contraceptive screening and counselling of women of reproductive age with unmet contraceptive needs

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    Table 20B:

    Summary of findings for contraceptive counselling of women of reproductive age with unmet contraceptive needs

    Table 20B:
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    Table 20C:

    Regional prevalence of use of main contraceptive methods, from most effective (sterilization) to least effective (periodic abstinence)626

    Table 20C:
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    Table 21A:

    Summary of findings for prophylactic HPV vaccination against cervical cancer in women

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    Table 21B:

    Summary of findings for organized screening program compared with opportunistic screening to prevent cervical cancer

    Table 21B:
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In this issue

Canadian Medical Association Journal: 183 (12)
CMAJ
Vol. 183, Issue 12
6 Sep 2011
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Evidence-based clinical guidelines for immigrants and refugees
Kevin Pottie, Christina Greenaway, John Feightner, Vivian Welch, Helena Swinkels, Meb Rashid, Lavanya Narasiah, Laurence J. Kirmayer, Erin Ueffing, Noni E. MacDonald, Ghayda Hassan, Mary McNally, Kamran Khan, Ralf Buhrmann, Sheila Dunn, Arunmozhi Dominic, Anne E. McCarthy, Anita J. Gagnon, Cécile Rousseau, Peter Tugwell, coauthors of the Canadian Collaboration for Immigrant and Refugee Health
CMAJ Sep 2011, 183 (12) E824-E925; DOI: 10.1503/cmaj.090313

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Evidence-based clinical guidelines for immigrants and refugees
Kevin Pottie, Christina Greenaway, John Feightner, Vivian Welch, Helena Swinkels, Meb Rashid, Lavanya Narasiah, Laurence J. Kirmayer, Erin Ueffing, Noni E. MacDonald, Ghayda Hassan, Mary McNally, Kamran Khan, Ralf Buhrmann, Sheila Dunn, Arunmozhi Dominic, Anne E. McCarthy, Anita J. Gagnon, Cécile Rousseau, Peter Tugwell, coauthors of the Canadian Collaboration for Immigrant and Refugee Health
CMAJ Sep 2011, 183 (12) E824-E925; DOI: 10.1503/cmaj.090313
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  • Article
    • Conditions covered in systematic reviews
    • Infectious diseases
    • Mental health and maltreatment
    • Chronic and noncommunicable diseases
    • Women’s health
    • 1. Overview: evidence-based clinical guidelines for immigrants and refugees
    • 2. Selection of potentially preventable and treatable conditions
    • 3. Evaluation of evidence-based literature and formulation of recommendations
    • 4. Measles, mumps, rubella, diphtheria, pertussis, tetanus and polio
    • 5. Varicella
    • 6. Hepatitis B
    • 7. Tuberculosis
    • 8. HIV
    • 9. Hepatitis C
    • 10. Intestinal parasites: Strongyloides and Schistosoma
    • 11. Malaria
    • 12. Depression
    • 13. Post-traumatic stress disorder
    • 14. Child maltreatment
    • 15. Intimate partner violence
    • 16. Type 2 diabetes mellitus
    • 17. Iron-deficiency anemia
    • 18. Dental disease
    • 19. Vision health
    • 20. Contraception
    • 21. Cervical cancer
    • 22. Pregnancy
    • Acknowledgements
    • Footnotes
    • References
  • Figures & Tables
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  • Prevention and assessment of infectious diseases among children and adult migrants arriving to the European Union/European Economic Association: a protocol for a suite of systematic reviews for public health and health systems
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  • Screening of Imported Infectious Diseases Among Asymptomatic Sub-Saharan African and Latin American Immigrants: A Public Health Challenge
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  • Hepatitis B virus screening and vaccination in a family from Nigeria
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  • Vitamin D status of refugees arriving in Canada: Findings from the Calgary Refugee Health Program
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More in this TOC Section

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  • Recommendations on screening for colorectal cancer in primary care
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