Amy L Davidow1, Dolly Katz1, Smita Ghosh1, Henry Blumberg1, Ashutosh Tamhane1, Anna Sevilla1, Randall Reves1. 1. Amy L. Davidow is with Rutgers Biological and Health Sciences, New Jersey Medical School, Department of Preventive Medicine and Community Health, Newark. Dolly Katz and Smita Ghosh are with Centers for Disease Control and Prevention, Division of TB Elimination, Atlanta, GA. Henry Blumberg is with Emory University School of Medicine, Department of Medicine, Atlanta. Ashutosh Tamhane is with University of Alabama at Birmingham, Department of Medicine. Anna Sevilla is with Global TB Institute, Rutgers Biological and Health Sciences. Randall Reves is with Denver Health and Hospitals Authority, Denver, CO.
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.
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.
Authors: Benjamin P Linas; Angela Y Wong; Kenneth A Freedberg; C Robert Horsburgh Journal: Am J Respir Crit Care Med Date: 2011-09-01 Impact factor: 21.405
Authors: Kimberly M Shea; J Steve Kammerer; Carla A Winston; Thomas R Navin; C Robert Horsburgh Journal: Am J Epidemiol Date: 2013-10-18 Impact factor: 4.897
Authors: Patrick K Moonan; Smita Ghosh; John E Oeltmann; J Steven Kammerer; Lauren S Cowan; Thomas R Navin Journal: Emerg Infect Dis Date: 2012-03 Impact factor: 6.883
Authors: Yecai Liu; John A Painter; Drew L Posey; Kevin P Cain; Michelle S Weinberg; Susan A Maloney; Luis S Ortega; Martin S Cetron Journal: PLoS One Date: 2012-02-27 Impact factor: 3.240
Authors: Lauren A Lambert; Lori R Armstrong; Mark N Lobato; Christine Ho; Anne Marie France; Maryam B Haddad Journal: Am J Public Health Date: 2016-09-15 Impact factor: 9.308
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: Andrea Parriott; Mohsen Malekinejad; Amanda P Miller; Hacsi Horvath; Suzanne M Marks; James G Kahn Journal: PLoS One Date: 2018-07-19 Impact factor: 3.240