BACKGROUND: Taiwan's criterion for admissions of new immigrants is a normal chest X-ray (CXR). Subsequent tuberculosis (TB) screening for new foreign spouses is mandatory before acquiring citizenship. OBJECTIVES: To estimate the TB burden among new-entry foreign spouses and their close contacts. RESULTS: Of 768 new foreign spouses with TB, of whom 98.6% were female, 721 (94.0%) had come from South-East Asian countries (Viet Nam, Indonesia, Philippines and Thailand) or China. Rates of TB (40.3-176.2 per 100 000/year) among newly emigrant wives aged 20-49 years were 1.7- to 7.3-fold higher than among Taiwanese females of corresponding ages. TB prevalence among the 2698 close contacts of 768 foreign spouse index cases was 1.2%, according to a 2-year follow-up investigation. Respectively 87.9% (675/768) and 11.1% (85/768) of all TB cases had abnormal and normal CXRs; of these, 35.4% (239/675) of patients with an abnormal and 14.1% (12/85) of those with a normal CXR were smear-negative, culture-positive. CONCLUSIONS: Foreign wives from endemic countries had a relatively high risk of TB. Regular TB screening of foreign spouses within at least 1-2 years of entry from TB-endemic regions, rather than after application for citizenship, is recommended. A more sensitive TB test could facilitate better diagnosis.
BACKGROUND: Taiwan's criterion for admissions of new immigrants is a normal chest X-ray (CXR). Subsequent tuberculosis (TB) screening for new foreign spouses is mandatory before acquiring citizenship. OBJECTIVES: To estimate the TB burden among new-entry foreign spouses and their close contacts. RESULTS: Of 768 new foreign spouses with TB, of whom 98.6% were female, 721 (94.0%) had come from South-East Asian countries (Viet Nam, Indonesia, Philippines and Thailand) or China. Rates of TB (40.3-176.2 per 100 000/year) among newly emigrant wives aged 20-49 years were 1.7- to 7.3-fold higher than among Taiwanese females of corresponding ages. TB prevalence among the 2698 close contacts of 768 foreign spouse index cases was 1.2%, according to a 2-year follow-up investigation. Respectively 87.9% (675/768) and 11.1% (85/768) of all TB cases had abnormal and normal CXRs; of these, 35.4% (239/675) of patients with an abnormal and 14.1% (12/85) of those with a normal CXR were smear-negative, culture-positive. CONCLUSIONS: Foreign wives from endemic countries had a relatively high risk of TB. Regular TB screening of foreign spouses within at least 1-2 years of entry from TB-endemic regions, rather than after application for citizenship, is recommended. A more sensitive TB test could facilitate better diagnosis.
Authors: F Naufal; L H Chaisson; K O Robsky; P Delgado-Barroso; H S Alvarez-Manzo; C R Miller; A E Shapiro; J E Golub Journal: Int J Tuberc Lung Dis Date: 2022-06-01 Impact factor: 3.427