American Journal of Respiratory and Critical Care Medicine
Volume 154, Issue 1, 1996, Pages 151-155

Tuberculosis screening for immigrants and refugees: Diagnostic outcomes in the State of Hawaii (Article)

Zuber P.L.F.* , Binkin N.J. , Ignacio A.C. , Marshall K.L. , Tribble S.P. , Tipple M.A. , Vogt R.L.
  • a Division of Tuberculosis Elimination, Centers for Dis. Contr. and Prev., Mailstop E-10, 1600 Clifton Road, Atlanta, GA 30333, United States
  • b [Affiliation not available]
  • c [Affiliation not available]
  • d [Affiliation not available]
  • e [Affiliation not available]
  • f [Affiliation not available]
  • g [Affiliation not available]

Abstract

The effectiveness of the required overseas tuberculosis (TB) screening for immigrants and refugees to the United States has not been evaluated since new guidelines were introduced in 1991. Using data from the Hawaii State TB register for 1992-1993, patient records, and data from the U.S. government notifications of suspect TB among aliens, we determined the percentage of persons either classified as having active TB (B1), inactive TB (B2), or considered 'normal' overseas, who were evaluated and subsequently diagnosed with active TB within 1 yr of arrival in the United States. Of the 124 TB cases among immigrants and refugees evaluated within 1 yr of arrival, 78 (63%) had been classified overseas as B1, 17 (14%) as B2, and 29 (23%) as 'normal.' The proportion of TB cases diagnosed after arrival in the United States was 14.0% for B1s and 2.1% for B2s. This proportion decreased with increasing age. A positive skin test was a strong predictor (OR: 10.7; 95% CI: 1.4-80.1) of culture-confirmed TB. These data document that immigrants and refugees with B1 and B2 TB status have a high prevalence of active TB. They should be promptly evaluated after arrival in the United States to determine the need for curative or preventive therapy.

Author Keywords

[No Keywords available]

Index Keywords

male female major clinical study tuberculosis immigrant Mycobacterium tuberculosis priority journal adult refugee Aged mass screening prevalence Article bacterium culture United States human tuberculin test Adolescent
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0030036723&doi=10.1164%2fajrccm.154.1.8680671&partnerID=40&md5=678166508b2bc4f14b0f6bded730b8f8
DOI: 10.1164/ajrccm.154.1.8680671
ISSN: 1073449X
Cited by: 37
Original Language: English