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. 2015 Sep;105(9):e81-8.
doi: 10.2105/AJPH.2015.302662. Epub 2015 Jul 16.

Preventing Infectious Pulmonary Tuberculosis Among Foreign-Born Residents of the United States

Amy L Davidow  1 , Dolly Katz  1 , Smita Ghosh  1 , Henry Blumberg  1 , Ashutosh Tamhane  1 , Anna Sevilla  1 , Randall Reves  1 ; Tuberculosis Epidemiologic Studies Consortium
Affiliations

Preventing Infectious Pulmonary Tuberculosis Among Foreign-Born Residents of the United States

Amy L Davidow et al. Am J Public Health. 2015 Sep.

Abstract

Objectives: We described risk factors associated with infectious tuberculosis (TB) and missed TB-prevention opportunities in foreign-born US residents, who account for almost two thirds of the nation's TB patients.

Methods: In a cross-sectional study at 20 US sites of foreign-born persons diagnosed with TB in 2005 through 2006, we collected results of sputum smear microscopy for acid-fast bacilli (a marker for infectiousness) and data on visa status, sociodemographics, TB-related care seeking, and latent TB infection (LTBI) diagnosis opportunities.

Results: Among 980 persons with pulmonary TB who reported their visa status, 601 (61%) were legal permanent residents, 131 (13.4%) had temporary visas, and 248 (25.3%) were undocumented. Undocumented persons were more likely than permanent residents to have acid-fast bacilli-positive smears at diagnosis (risk ratio = 1.3; 95% confidence interval = 1.2, 1.4). Of those diagnosed 1 year or more after arrival, 57.3% reported LTBI screening opportunities; fewer than 25% actually were. Undocumented persons reported fewer LTBI screening opportunities and were less likely to be tested.

Conclusions: Progress toward TB elimination in the United States depends upon expanding opportunities for regular medical care and promotion of LTBI screening and treatment among foreign-born persons.

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Comment in

  • Davidow Responds.
    Davidow AL. Davidow AL. Am J Public Health. 2015 Dec;105(12):e3-4. doi: 10.2105/AJPH.2015.302917. Epub 2015 Oct 15. Am J Public Health. 2015. PMID: 26469645 Free PMC article. No abstract available.
  • Missed Opportunity to Prevent Tuberculosis.
    Shin SS, Hsu T, Chavez E, Chang AH, Kerndt PR. Shin SS, et al. Am J Public Health. 2015 Dec;105(12):e3. doi: 10.2105/AJPH.2015.302895. Epub 2015 Oct 15. Am J Public Health. 2015. PMID: 26469664 Free PMC article. No abstract available.

References

    1. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2013. Reported tuberculosis in the United States, 2012.
    1. Shah NS, Cavanaugh JS, Pratt R et al. Epidemiology of smear-negative pulmonary tuberculosis in the United States, 1993–2008. Int J Tuberc Lung Dis. 2012;16(9):1234–1240. - PubMed
    1. Tostmann A, Kik SV, Kalisvaart NA et al. Tuberculosis transmission by patients with smear-negative pulmonary tuberculosis in a large cohort in the Netherlands. Clin Infect Dis. 2008;47(9):1135–1142. - PubMed
    1. Behr MA, Warren SA, Salamon H et al. Transmission of Mycobacterium tuberculosis from patients smear-negative for acid-fast bacilli. Lancet. 1999;353(9151):444–449. - PubMed
    1. Moonan PK, Ghosh S, Oeltmann JE, Kammerer JS, Cowan LS, Navin TR. Using genotyping and geospatial scanning to estimate recent Mycobacterium tuberculosis transmission, United States. Emerg Infect Dis. 2012;18(3):458–465. - PMC - PubMed

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