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Tuberculosis among foreign-born persons in the United States.
JAMA. 2008 Jul 23; 300(4):405-12.JAMA

Abstract

CONTEXT

Foreign-born persons accounted for 57% of all tuberculosis (TB) cases in the United States in 2006. Current TB control strategies have not sufficiently addressed the high levels of TB disease and latent TB infection in this population.

OBJECTIVE

To determine the risk of TB disease and drug-resistant TB among foreign-born populations and the potential impact of adding TB culture to overseas screening procedures for foreign-born persons entering the United States.

DESIGN, SETTING, AND PARTICIPANTS

Descriptive epidemiologic analysis of foreign-born persons in the United States diagnosed with TB from 2001 through 2006.

MAIN OUTCOME MEASURES

TB case rates, stratified by time since US entry, country of origin, and age at US entry; anti-TB drug-resistance patterns; and characteristics of TB cases diagnosed within 3 months of US entry.

RESULTS

A total of 46,970 cases of TB disease were reported among foreign-born persons in the United States from 2001 through 2006, of which 12,928 (28%) were among recent entrants (within 2 years of US entry). Among the foreign-born population overall, TB case rates declined with increasing time since US entry, but remained higher than among US-born persons--even more than 20 years after arrival. In total, 53% of TB cases among foreign-born persons occurred among the 22% of the foreign-born population born in sub-Saharan Africa and Southeast Asia. Isoniazid resistance was as high as 20% among recent entrants from Vietnam and 18% for recent entrants from Peru. On average, 250 individuals per year were diagnosed with smear-negative, culture-positive TB disease within 3 months of US entry; 46% of these were from the Philippines or Vietnam.

CONCLUSION

The relative yield of finding and treating latent TB infection is particularly high among individuals from most countries of sub-Saharan Africa and Southeast Asia.

Authors+Show Affiliations

Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-E-10, Atlanta, GA 30333, USA. kcain@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18647983

Citation

Cain, Kevin P., et al. "Tuberculosis Among Foreign-born Persons in the United States." JAMA, vol. 300, no. 4, 2008, pp. 405-12.
Cain KP, Benoit SR, Winston CA, et al. Tuberculosis among foreign-born persons in the United States. JAMA. 2008;300(4):405-12.
Cain, K. P., Benoit, S. R., Winston, C. A., & Mac Kenzie, W. R. (2008). Tuberculosis among foreign-born persons in the United States. JAMA, 300(4), 405-12. https://doi.org/10.1001/jama.300.4.405
Cain KP, et al. Tuberculosis Among Foreign-born Persons in the United States. JAMA. 2008 Jul 23;300(4):405-12. PubMed PMID: 18647983.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tuberculosis among foreign-born persons in the United States. AU - Cain,Kevin P, AU - Benoit,Stephen R, AU - Winston,Carla A, AU - Mac Kenzie,William R, PY - 2008/7/24/pubmed PY - 2008/7/30/medline PY - 2008/7/24/entrez SP - 405 EP - 12 JF - JAMA JO - JAMA VL - 300 IS - 4 N2 - CONTEXT: Foreign-born persons accounted for 57% of all tuberculosis (TB) cases in the United States in 2006. Current TB control strategies have not sufficiently addressed the high levels of TB disease and latent TB infection in this population. OBJECTIVE: To determine the risk of TB disease and drug-resistant TB among foreign-born populations and the potential impact of adding TB culture to overseas screening procedures for foreign-born persons entering the United States. DESIGN, SETTING, AND PARTICIPANTS: Descriptive epidemiologic analysis of foreign-born persons in the United States diagnosed with TB from 2001 through 2006. MAIN OUTCOME MEASURES: TB case rates, stratified by time since US entry, country of origin, and age at US entry; anti-TB drug-resistance patterns; and characteristics of TB cases diagnosed within 3 months of US entry. RESULTS: A total of 46,970 cases of TB disease were reported among foreign-born persons in the United States from 2001 through 2006, of which 12,928 (28%) were among recent entrants (within 2 years of US entry). Among the foreign-born population overall, TB case rates declined with increasing time since US entry, but remained higher than among US-born persons--even more than 20 years after arrival. In total, 53% of TB cases among foreign-born persons occurred among the 22% of the foreign-born population born in sub-Saharan Africa and Southeast Asia. Isoniazid resistance was as high as 20% among recent entrants from Vietnam and 18% for recent entrants from Peru. On average, 250 individuals per year were diagnosed with smear-negative, culture-positive TB disease within 3 months of US entry; 46% of these were from the Philippines or Vietnam. CONCLUSION: The relative yield of finding and treating latent TB infection is particularly high among individuals from most countries of sub-Saharan Africa and Southeast Asia. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/18647983/Tuberculosis_among_foreign_born_persons_in_the_United_States_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.300.4.405 DB - PRIME DP - Unbound Medicine ER -