BACKGROUND: Before 2007, immigrants and refugees bound for the United States were screened for tuberculosis (TB) by a smear-based algorithm that could not diagnose smear-negative/culture-positive TB. In 2007, the Centers for Disease Control and Prevention implemented a culture-based algorithm. OBJECTIVE: To evaluate the effect of the culture-based algorithm on preventing the importation of TB to the United States by immigrants and refugees from foreign countries. DESIGN: Population-based, cross-sectional study. SETTING: Panel physician sites for overseas medical examination. PATIENTS: Immigrants and refugees with TB. MEASUREMENTS: Comparison of the increase of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees by the culture-based algorithm with the decline of reported cases among foreign-born persons within 1 year after arrival in the United States from 2007 to 2012. RESULTS: Of the 3 212 421 arrivals of immigrants and refugees from 2007 to 2012, a total of 1 650 961 (51.4%) were screened by the smear-based algorithm and 1 561 460 (48.6%) were screened by the culture-based algorithm. Among the 4032 TB cases diagnosed by the culture-based algorithm, 2195 (54.4%) were smear-negative/culture-positive. Before implementation (2002 to 2006), the annual number of reported cases among foreign-born persons within 1 year after arrival was relatively constant (range, 1424 to 1626 cases; mean, 1504 cases) but decreased from 1511 to 940 cases during implementation (2007 to 2012). During the same period, the annual number of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees bound for the United States by the culture-based algorithm increased from 4 to 629. LIMITATION: This analysis did not control for the decline in new arrivals of nonimmigrant visitors to the United States and the decrease of incidence of TB in their countries of origin. CONCLUSION: Implementation of the culture-based algorithm may have substantially reduced the incidence of TB among newly arrived, foreign-born persons in the United States. PRIMARY FUNDING SOURCE: None.
BACKGROUND: Before 2007, immigrants and refugees bound for the United States were screened for tuberculosis (TB) by a smear-based algorithm that could not diagnose smear-negative/culture-positive TB. In 2007, the Centers for Disease Control and Prevention implemented a culture-based algorithm. OBJECTIVE: To evaluate the effect of the culture-based algorithm on preventing the importation of TB to the United States by immigrants and refugees from foreign countries. DESIGN: Population-based, cross-sectional study. SETTING: Panel physician sites for overseas medical examination. PATIENTS: Immigrants and refugees with TB. MEASUREMENTS: Comparison of the increase of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees by the culture-based algorithm with the decline of reported cases among foreign-born persons within 1 year after arrival in the United States from 2007 to 2012. RESULTS: Of the 3 212 421 arrivals of immigrants and refugees from 2007 to 2012, a total of 1 650 961 (51.4%) were screened by the smear-based algorithm and 1 561 460 (48.6%) were screened by the culture-based algorithm. Among the 4032 TB cases diagnosed by the culture-based algorithm, 2195 (54.4%) were smear-negative/culture-positive. Before implementation (2002 to 2006), the annual number of reported cases among foreign-born persons within 1 year after arrival was relatively constant (range, 1424 to 1626 cases; mean, 1504 cases) but decreased from 1511 to 940 cases during implementation (2007 to 2012). During the same period, the annual number of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees bound for the United States by the culture-based algorithm increased from 4 to 629. LIMITATION: This analysis did not control for the decline in new arrivals of nonimmigrant visitors to the United States and the decrease of incidence of TB in their countries of origin. CONCLUSION: Implementation of the culture-based algorithm may have substantially reduced the incidence of TB among newly arrived, foreign-born persons in the United States. PRIMARY FUNDING SOURCE: None.
Authors: Diane E Bennett; Jeanne M Courval; Ida Onorato; Tracy Agerton; Judy D Gibson; Lauren Lambert; Geraldine M McQuillan; Brenda Lewis; Thomas R Navin; Kenneth G Castro Journal: Am J Respir Crit Care Med Date: 2007-11-07 Impact factor: 21.405
Authors: Susan A Maloney; Katherine L Fielding; Kayla F Laserson; Warren Jones; Thi Ngoc Yen Nguyen; Quy An Dang; Huu Phuoc Nguyen; An Trinh Nguyen; Thi Cam Nhung Duong; Thi Chi Mai Vo; M Frank Seawright; Thomas O'Rourke; Xuan Lien Truong; Thi Ngoc Lan Nguyen; Nancy Binkin; Martin S Cetron Journal: Arch Intern Med Date: 2006-01-23
Authors: John E Oeltmann; Jay K Varma; Luis Ortega; Yecai Liu; Thomas O'Rourke; Maria Cano; Theresa Harrington; Sean Toney; Warren Jones; Samart Karuchit; Lois Diem; Dhanida Rienthong; Jordan W Tappero; Kashef Ijaz; Susan A Maloney Journal: Emerg Infect Dis Date: 2008-11 Impact factor: 6.883
Authors: Drew L Posey; Mary P Naughton; Erika A Willacy; Michelle Russell; Christine K Olson; Courtney M Godwin; Pamela S McSpadden; Zachary A White; Terry W Comans; Luis S Ortega; Michael Guterbock; Michelle S Weinberg; Martin S Cetron Journal: MMWR Morb Mortal Wkly Rep Date: 2014-03-21 Impact factor: 17.586
Authors: Kristine M Schmit; Richard Brostrom; Angela Largen; Alexandra Pyan; Zanju Wang; Sundari Mase; Sapna Morris Journal: J Immigr Minor Health Date: 2019-12
Authors: Nathan W Furukawa; Mahri Z Haider; Sheanne J Allen; Sherry L Carlson; Scott W Lindquist Journal: Am J Trop Med Hyg Date: 2017-04-06 Impact factor: 2.345
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
Authors: Yecai Liu; Christina R Phares; Drew L Posey; Susan A Maloney; Kevin P Cain; Michelle S Weinberg; Kristine M Schmit; Nina Marano; Martin S Cetron Journal: Ann Am Thorac Soc Date: 2020-11
Authors: Shareen A Iqbal; Carla A Winston; Barbara H Bardenheier; Lori R Armstrong; Thomas R Navin Journal: Am J Public Health Date: 2018-11 Impact factor: 9.308
Authors: P B Shete; D Boccia; P Dhavan; N Gebreselassie; K Lönnroth; S Marks; A Matteelli; D L Posey; M J van der Werf; C A Winston; C Lienhardt Journal: Int J Tuberc Lung Dis Date: 2018-08-01 Impact factor: 2.373
Authors: D A Black; S W McBrien; J Gersh; B Ghassemieh; M Narita; M J Pecha; Y Tan; D J Horne Journal: Int J Tuberc Lung Dis Date: 2021-07-01 Impact factor: 2.373