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Reduced importation of tuberculosis after the implementation of an enhanced pre-immigration screening protocol.
Int J Tuberc Lung Dis. 2011 Jun; 15(6):761-6.IJ

Abstract

SETTING

Importation of infectious tuberculosis (TB) threatens TB control in California and the United States.

OBJECTIVE

To assess the effectiveness of an enhanced pre-immigration screening and treatment protocol to prevent the importation of infectious TB.

DESIGN

Retrospective analysis of immigrants ≥ 15 years of age with TB suspect classifications who were screened for TB in their countries of origin before (pre-intervention cohort) and after (post-intervention cohort) implementation of enhanced pre-immigration screening. Enhanced pre-immigration screening added sputum cultures to the existing screening system based on sputum smears for persons with abnormal chest radiographs.

RESULTS

The pre- and post-intervention cohorts included respectively 2049 and 1430 immigrants. The occurrence of tuberculosis ≤ 6 months after US arrival in this population decreased following the intervention, from 4.2% (86 cases) to 1.5% (22 cases, P < 0.001). Among pre-intervention cohort cases, 14% were sputum acid-fast bacilli (AFB) smear-positive and 81% were sputum culture-positive for TB, compared with 5% sputum AFB smear-positive (P = 0.46) and 68% sputum culture-positive (P = 0.18) among the post-intervention cohort cases.

CONCLUSION

The enhanced pre-immigration screening was associated with a decline in the proportion of immigrants with TB suspect classifications identified with TB within 6 months of arrival in the United States. Continued state and national surveillance is critical to monitor the effectiveness of the revised pre-immigration screening as it is implemented in additional countries.

Authors+Show Affiliations

California Department of Public Health, Tuberculosis Control Branch, Richmond, California 94804-6403, USA. phil.lowenthal@cdph.ca.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

21575295

Citation

Lowenthal, P, et al. "Reduced Importation of Tuberculosis After the Implementation of an Enhanced Pre-immigration Screening Protocol." The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease, vol. 15, no. 6, 2011, pp. 761-6.
Lowenthal P, Westenhouse J, Moore M, et al. Reduced importation of tuberculosis after the implementation of an enhanced pre-immigration screening protocol. Int J Tuberc Lung Dis. 2011;15(6):761-6.
Lowenthal, P., Westenhouse, J., Moore, M., Posey, D. L., Watt, J. P., & Flood, J. (2011). Reduced importation of tuberculosis after the implementation of an enhanced pre-immigration screening protocol. The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease, 15(6), 761-6. https://doi.org/10.5588/ijtld.10.0370
Lowenthal P, et al. Reduced Importation of Tuberculosis After the Implementation of an Enhanced Pre-immigration Screening Protocol. Int J Tuberc Lung Dis. 2011;15(6):761-6. PubMed PMID: 21575295.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced importation of tuberculosis after the implementation of an enhanced pre-immigration screening protocol. AU - Lowenthal,P, AU - Westenhouse,J, AU - Moore,M, AU - Posey,D L, AU - Watt,J P, AU - Flood,J, PY - 2011/5/18/entrez PY - 2011/5/18/pubmed PY - 2012/2/22/medline SP - 761 EP - 6 JF - The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease JO - Int J Tuberc Lung Dis VL - 15 IS - 6 N2 - SETTING: Importation of infectious tuberculosis (TB) threatens TB control in California and the United States. OBJECTIVE: To assess the effectiveness of an enhanced pre-immigration screening and treatment protocol to prevent the importation of infectious TB. DESIGN: Retrospective analysis of immigrants ≥ 15 years of age with TB suspect classifications who were screened for TB in their countries of origin before (pre-intervention cohort) and after (post-intervention cohort) implementation of enhanced pre-immigration screening. Enhanced pre-immigration screening added sputum cultures to the existing screening system based on sputum smears for persons with abnormal chest radiographs. RESULTS: The pre- and post-intervention cohorts included respectively 2049 and 1430 immigrants. The occurrence of tuberculosis ≤ 6 months after US arrival in this population decreased following the intervention, from 4.2% (86 cases) to 1.5% (22 cases, P < 0.001). Among pre-intervention cohort cases, 14% were sputum acid-fast bacilli (AFB) smear-positive and 81% were sputum culture-positive for TB, compared with 5% sputum AFB smear-positive (P = 0.46) and 68% sputum culture-positive (P = 0.18) among the post-intervention cohort cases. CONCLUSION: The enhanced pre-immigration screening was associated with a decline in the proportion of immigrants with TB suspect classifications identified with TB within 6 months of arrival in the United States. Continued state and national surveillance is critical to monitor the effectiveness of the revised pre-immigration screening as it is implemented in additional countries. SN - 1815-7920 UR - https://www.unboundmedicine.com/medline/citation/21575295/full_citation L2 - https://www.ingentaconnect.com/openurl?genre=article&amp;issn=1027-3719&amp;volume=15&amp;issue=6&amp;spage=761&amp;aulast=Lowenthal DB - PRIME DP - Unbound Medicine ER -