Jamie P Morano1, Alexei Zelenev, Mary R Walton, R Douglas Bruce, Frederick L Altice. 1. Jamie P. Morano, Alexei Zelenev, Mary R. Walton, R. Douglas Bruce, and Frederick L. Altice are with the Yale School of Medicine, Department of Infectious Diseases, Yale University AIDS Program, New Haven, CT. R. D. Bruce and F. L. Altice are also affiliated with the Yale School of Public Health, Division of Epidemiology of Microbial Diseases, New Haven. F. L. Altice is also associated with the Centre of Excellence in Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia.
Abstract
OBJECTIVES: We evaluated the efficacy of a mobile medical clinic (MMC) screening program for detecting latent tuberculosis infection (LTBI) and active tuberculosis. METHODS: A LTBI screening program in a MMC in New Haven, Connecticut, used medical surveys to examine risk factors and tuberculin skin test (TST) screening eligibility. We assessed clinically relevant correlates of total (prevalent; n = 4650) and newly diagnosed (incident; n = 4159) LTBI from 2003 to 2011. RESULTS: Among 8322 individuals, 4159 (55.6%) met TST screening eligibility criteria, of which 1325 (31.9%) had TST assessed. Similar to LTBI prevalence (16.8%; 779 of 4650), newly diagnosed LTBI (25.6%; 339 of 1325) was independently correlated with being foreign-born (adjusted odds ratio [AOR] = 8.49; 95% confidence interval [CI] = 5.54, 13.02), Hispanic (AOR = 3.12; 95% CI = 1.88, 5.20), Black (AOR = 2.16; 95% CI = 1.31, 3.55), employed (AOR = 1.61; 95% CI = 1.14, 2.28), and of increased age (AOR = 1.04; 95% CI = 1.02, 1.05). Unstable housing (AOR = 4.95; 95% CI = 3.43, 7.14) and marijuana use (AOR = 1.57; 95% CI = 1.05, 2.37) were significantly correlated with incident LTBI, and being male, heroin use, interpersonal violence, employment, not having health insurance, and not completing high school were significantly correlated with prevalent LTBI. CONCLUSIONS: Screening for TST in MMCs successfully identifies high-risk foreign-born, Hispanic, working, and uninsured populations and innovatively identifies LTBI in urban settings.
OBJECTIVES: We evaluated the efficacy of a mobile medical clinic (MMC) screening program for detecting latent tuberculosis infection (LTBI) and active tuberculosis. METHODS: A LTBI screening program in a MMC in New Haven, Connecticut, used medical surveys to examine risk factors and tuberculin skin test (TST) screening eligibility. We assessed clinically relevant correlates of total (prevalent; n = 4650) and newly diagnosed (incident; n = 4159) LTBI from 2003 to 2011. RESULTS: Among 8322 individuals, 4159 (55.6%) met TST screening eligibility criteria, of which 1325 (31.9%) had TST assessed. Similar to LTBI prevalence (16.8%; 779 of 4650), newly diagnosed LTBI (25.6%; 339 of 1325) was independently correlated with being foreign-born (adjusted odds ratio [AOR] = 8.49; 95% confidence interval [CI] = 5.54, 13.02), Hispanic (AOR = 3.12; 95% CI = 1.88, 5.20), Black (AOR = 2.16; 95% CI = 1.31, 3.55), employed (AOR = 1.61; 95% CI = 1.14, 2.28), and of increased age (AOR = 1.04; 95% CI = 1.02, 1.05). Unstable housing (AOR = 4.95; 95% CI = 3.43, 7.14) and marijuana use (AOR = 1.57; 95% CI = 1.05, 2.37) were significantly correlated with incident LTBI, and being male, heroin use, interpersonal violence, employment, not having health insurance, and not completing high school were significantly correlated with prevalent LTBI. CONCLUSIONS: Screening for TST in MMCs successfully identifies high-risk foreign-born, Hispanic, working, and uninsured populations and innovatively identifies LTBI in urban settings.
Authors: Linda Weiss; Julie Netherland; James E Egan; Timothy P Flanigan; David A Fiellin; Ruth Finkelstein; Frederick L Altice Journal: J Acquir Immune Defic Syndr Date: 2011-03-01 Impact factor: 3.731
Authors: Timothy R Sterling; M Elsa Villarino; Andrey S Borisov; Nong Shang; Fred Gordin; Erin Bliven-Sizemore; Judith Hackman; Carol Dukes Hamilton; Dick Menzies; Amy Kerrigan; Stephen E Weis; Marc Weiner; Diane Wing; Marcus B Conde; Lorna Bozeman; C Robert Horsburgh; Richard E Chaisson Journal: N Engl J Med Date: 2011-12-08 Impact factor: 91.245
Authors: Neela D Goswami; Lara Beth Gadkowski; Carla Piedrahita; Deborah Bissette; Marshall Alex Ahearn; Michela L M Blain; Truls Østbye; Jussi Saukkonen; Jason E Stout Journal: BMC Public Health Date: 2012-06-21 Impact factor: 3.295
Authors: Jamie P Morano; Alexei Zelenev; Andrea Lombard; Ruthanne Marcus; Britton A Gibson; Frederick L Altice Journal: J Community Health Date: 2014-10
Authors: Mohsen Malekinejad; Andrea Parriott; Amanda P Viitanen; Hacsi Horvath; Suzanne M Marks; James G Kahn Journal: PLoS One Date: 2017-08-07 Impact factor: 3.240
Authors: Christian Herzmann; Giovanni Sotgiu; Oswald Bellinger; Roland Diel; Silke Gerdes; Udo Goetsch; Helga Heykes-Uden; Tom Schaberg; Christoph Lange Journal: Infection Date: 2016-11-19 Impact factor: 3.553
Authors: Clare E French; Caroline M Coope; Luke A McGuinness; Charles R Beck; Sophie Newitt; Lauren Ahyow; Matt Hickman; Isabel Oliver Journal: BMC Public Health Date: 2019-07-27 Impact factor: 3.295
Authors: Julia Rosenberg; Leslie Sude; Mariana Budge; Daisy León-Martínez; Ada Fenick; Frederick L Altice; Mona Sharifi Journal: Matern Child Health J Date: 2022-07-28