International Journal of Tuberculosis and Lung Disease
Volume 19, Issue 5, 2015, Pages 565-569

Evaluation of latent tuberculous infection and treatment completion for refugees in Philadelphia, PA, 2010-2012 (Article)

Subedi P. , Drezner K.A.* , Dogbey M.C. , Newbern E.C. , Yun K. , Scott K.C. , Garland J.M. , Altshuler M.J. , Johnson C.C.
  • a Philadelphia Department of Public Health, University of Pennsylvania, Philadelphia, PA, United States
  • b Philadelphia Department of Public Health, University of Pennsylvania, Philadelphia, PA, United States
  • c Philadelphia Department of Public Health, University of Pennsylvania, Philadelphia, PA, United States
  • d Philadelphia Department of Public Health, University of Pennsylvania, Philadelphia, PA, United States
  • e Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States, Philadelphia Refugee Health Collaborative, University of Pennsylvania, Philadelphia, PA, United States
  • f Philadelphia Refugee Health Collaborative, University of Pennsylvania, Philadelphia, PA, United States, Thomas Jefferson University Hospital, University of Pennsylvania, Philadelphia, PA, United States
  • g Thomas Jefferson University Hospital, University of Pennsylvania, Philadelphia, PA, United States, Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
  • h Philadelphia Refugee Health Collaborative, University of Pennsylvania, Philadelphia, PA, United States, Thomas Jefferson University Hospital, University of Pennsylvania, Philadelphia, PA, United States
  • i Philadelphia Department of Public Health, University of Pennsylvania, Philadelphia, PA, United States

Abstract

SETTING: Philadelphia, PA, USA. OBJECTIVES: To compare the evaluation and treatment of latent tuberculous infection (LTBI) in refugees seen at member clinics of the Philadelphia Refugee Health Collaborative (PRHC) vs. non-PRHC clinics. DESIGN: Refugees with Class B (non-communicable) tuberculosis (TB) admitted to the United States from 2010 to 2012 who were being treated at PRHC clinics were compared to those treated at non-PRHC clinics. Odds ratios (ORs) for attending a follow-up appointment, completing treatment, and time from arrival to the United States to the first TB screening test were calculated. RESULTS: Of the 2094 refugees who arrived in Philadelphia in 2010-2012, the Philadelphia Department of Public Health was notified of 149 who required additional evaluation for TB. Among these, 57 (38.3%) were confirmed to have LTBI, and none were diagnosed with active TB. All LTBI cases were recommended for anti-tuberculosis prophylaxis and 43 (75.4%) completed treatment. Refugees receiving care from PRHC clinics were more likely to be screened within 30 days of arrival (OR 4.70, 95%CI 2.12-10.44), attend a follow-up appointment (OR 4.53, 95%CI 1.36-16.27), and complete treatment (OR 9.44, 95%CI 2.39-37.3). CONCLUSION: Refugees who attended PRHC clinics were more likely to be evaluated promptly and to complete LTBI treatment. The PRHC clinics serve as a model for communities seeking to improve refugee health care. © 2015 The Union.

Author Keywords

Refugees Public Health/communicable disease control Disease notification LTBI

Index Keywords

disease classification refugee mass screening sex ratio follow up human Refugees middle aged Odds Ratio Cohort Studies statistics and numerical data interferon gamma release assay Confidence Intervals priority journal controlled study comparative study screening test medication compliance Pennsylvania procedures Confidence interval United States Humans Sputum Philadelphia tuberculostatic agent Antitubercular Agents Treatment Outcome male latent tuberculosis female evaluation study Ambulatory Care Facilities outpatient department Incidence Article Disease Notification Retrospective Studies infection control patient compliance major clinical study tuberculin test adult thorax radiography Sex Distribution tuberculosis control age distribution microbiology cohort analysis chemoprophylaxis health center retrospective study Radiography, Thoracic Medication Adherence Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84928894097&doi=10.5588%2fijtld.14.0729&partnerID=40&md5=d39afdee730f204a59dcc1f37c536bc1
DOI: 10.5588/ijtld.14.0729
ISSN: 10273719
Cited by: 4
Original Language: English