Tuberculosis among Newly Arrived Immigrants and Refugees in the United States
U.S. health departments routinely conduct post-arrival evaluation of immigrants and refugees at risk for tuberculosis (TB), but this important intervention has not been thoroughly studied. To assess outcomes of the post-arrival evaluation intervention. We categorized at-risk immigrants and refugees...
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Veröffentlicht in: | Annals of the American Thoracic Society 2020-11, Vol.17 (11), p.1401-1412 |
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description | U.S. health departments routinely conduct post-arrival evaluation of immigrants and refugees at risk for tuberculosis (TB), but this important intervention has not been thoroughly studied.
To assess outcomes of the post-arrival evaluation intervention.
We categorized at-risk immigrants and refugees as having had recent completion of treatment for pulmonary TB disease overseas (including in Mexico and Canada); as having suspected TB disease (chest radiograph/clinical symptoms suggestive of TB) but negative culture results overseas; or as having latent TB infection (LTBI) diagnosed overseas. Among 2.1 million U.S.-bound immigrants and refugees screened for TB overseas during 2013-2016, 90,737 were identified as at risk for TB. We analyzed a national data set of these at-risk immigrants and refugees and calculated rates of TB disease for those who completed post-arrival evaluation.
Among 4,225 persons with recent completion of treatment for pulmonary TB disease overseas, 3,005 (71.1%) completed post-arrival evaluation within 1 year of arrival; of these, TB disease was diagnosed in 22 (732 cases/100,000 persons), including 4 sputum culture-positive cases (133 cases/100,000 persons), 13 sputum culture-negative cases (433 cases/100,000 persons), and 5 cases with no reported sputum-culture results (166 cases/100,000 persons). Among 55,938 with suspected TB disease but negative culture results overseas, 37,089 (66.3%) completed post-arrival evaluation; of these, TB disease was diagnosed in 597 (1,610 cases/100,000 persons), including 262 sputum culture-positive cases (706 cases/100,000 persons), 281 sputum culture-negative cases (758 cases/100,000 persons), and 54 cases with no reported sputum-culture results (146 cases/100,000 persons). Among 30,574 with LTBI diagnosed overseas, 18,466 (60.4%) completed post-arrival evaluation; of these, TB disease was diagnosed in 48 (260 cases/100,000 persons), including 11 sputum culture-positive cases (60 cases/100,000 persons), 22 sputum culture-negative cases (119 cases/100,000 persons), and 15 cases with no reported sputum-culture results (81 cases/100,000 persons). Of 21,714 persons for whom treatment for LTBI was recommended at post-arrival evaluation, 14,977 (69.0%) initiated treatment and 8,695 (40.0%) completed treatment.
Post-arrival evaluation of at-risk immigrants and refugees can be highly effective. To optimize the yield and impact of this intervention, strategies are needed to improve completion rates of post-ar |
doi_str_mv | 10.1513/AnnalsATS.201908-623OC |
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To assess outcomes of the post-arrival evaluation intervention.
We categorized at-risk immigrants and refugees as having had recent completion of treatment for pulmonary TB disease overseas (including in Mexico and Canada); as having suspected TB disease (chest radiograph/clinical symptoms suggestive of TB) but negative culture results overseas; or as having latent TB infection (LTBI) diagnosed overseas. Among 2.1 million U.S.-bound immigrants and refugees screened for TB overseas during 2013-2016, 90,737 were identified as at risk for TB. We analyzed a national data set of these at-risk immigrants and refugees and calculated rates of TB disease for those who completed post-arrival evaluation.
Among 4,225 persons with recent completion of treatment for pulmonary TB disease overseas, 3,005 (71.1%) completed post-arrival evaluation within 1 year of arrival; of these, TB disease was diagnosed in 22 (732 cases/100,000 persons), including 4 sputum culture-positive cases (133 cases/100,000 persons), 13 sputum culture-negative cases (433 cases/100,000 persons), and 5 cases with no reported sputum-culture results (166 cases/100,000 persons). Among 55,938 with suspected TB disease but negative culture results overseas, 37,089 (66.3%) completed post-arrival evaluation; of these, TB disease was diagnosed in 597 (1,610 cases/100,000 persons), including 262 sputum culture-positive cases (706 cases/100,000 persons), 281 sputum culture-negative cases (758 cases/100,000 persons), and 54 cases with no reported sputum-culture results (146 cases/100,000 persons). Among 30,574 with LTBI diagnosed overseas, 18,466 (60.4%) completed post-arrival evaluation; of these, TB disease was diagnosed in 48 (260 cases/100,000 persons), including 11 sputum culture-positive cases (60 cases/100,000 persons), 22 sputum culture-negative cases (119 cases/100,000 persons), and 15 cases with no reported sputum-culture results (81 cases/100,000 persons). Of 21,714 persons for whom treatment for LTBI was recommended at post-arrival evaluation, 14,977 (69.0%) initiated treatment and 8,695 (40.0%) completed treatment.
Post-arrival evaluation of at-risk immigrants and refugees can be highly effective. To optimize the yield and impact of this intervention, strategies are needed to improve completion rates of post-arrival evaluation and treatment for LTBI.</description><identifier>ISSN: 2329-6933</identifier><identifier>ISSN: 2325-6621</identifier><identifier>EISSN: 2325-6621</identifier><identifier>DOI: 10.1513/AnnalsATS.201908-623OC</identifier><identifier>PMID: 32730094</identifier><language>eng</language><publisher>United States: American Thoracic Society</publisher><subject>Emigrants and Immigrants ; Humans ; Intervention ; Latent Tuberculosis - diagnosis ; Latent Tuberculosis - epidemiology ; Mass Screening ; Noncitizens ; Refugees ; Tuberculosis ; United States - epidemiology</subject><ispartof>Annals of the American Thoracic Society, 2020-11, Vol.17 (11), p.1401-1412</ispartof><rights>Copyright American Thoracic Society Nov 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-8e3f4a2815ff03500465aacd80dbc10abda3fd2622856124bcb66762b9b43d663</citedby><cites>FETCH-LOGICAL-c442t-8e3f4a2815ff03500465aacd80dbc10abda3fd2622856124bcb66762b9b43d663</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32730094$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Yecai</creatorcontrib><creatorcontrib>Phares, Christina R</creatorcontrib><creatorcontrib>Posey, Drew L</creatorcontrib><creatorcontrib>Maloney, Susan A</creatorcontrib><creatorcontrib>Cain, Kevin P</creatorcontrib><creatorcontrib>Weinberg, Michelle S</creatorcontrib><creatorcontrib>Schmit, Kristine M</creatorcontrib><creatorcontrib>Marano, Nina</creatorcontrib><creatorcontrib>Cetron, Martin S</creatorcontrib><title>Tuberculosis among Newly Arrived Immigrants and Refugees in the United States</title><title>Annals of the American Thoracic Society</title><addtitle>Ann Am Thorac Soc</addtitle><description>U.S. health departments routinely conduct post-arrival evaluation of immigrants and refugees at risk for tuberculosis (TB), but this important intervention has not been thoroughly studied.
To assess outcomes of the post-arrival evaluation intervention.
We categorized at-risk immigrants and refugees as having had recent completion of treatment for pulmonary TB disease overseas (including in Mexico and Canada); as having suspected TB disease (chest radiograph/clinical symptoms suggestive of TB) but negative culture results overseas; or as having latent TB infection (LTBI) diagnosed overseas. Among 2.1 million U.S.-bound immigrants and refugees screened for TB overseas during 2013-2016, 90,737 were identified as at risk for TB. We analyzed a national data set of these at-risk immigrants and refugees and calculated rates of TB disease for those who completed post-arrival evaluation.
Among 4,225 persons with recent completion of treatment for pulmonary TB disease overseas, 3,005 (71.1%) completed post-arrival evaluation within 1 year of arrival; of these, TB disease was diagnosed in 22 (732 cases/100,000 persons), including 4 sputum culture-positive cases (133 cases/100,000 persons), 13 sputum culture-negative cases (433 cases/100,000 persons), and 5 cases with no reported sputum-culture results (166 cases/100,000 persons). Among 55,938 with suspected TB disease but negative culture results overseas, 37,089 (66.3%) completed post-arrival evaluation; of these, TB disease was diagnosed in 597 (1,610 cases/100,000 persons), including 262 sputum culture-positive cases (706 cases/100,000 persons), 281 sputum culture-negative cases (758 cases/100,000 persons), and 54 cases with no reported sputum-culture results (146 cases/100,000 persons). Among 30,574 with LTBI diagnosed overseas, 18,466 (60.4%) completed post-arrival evaluation; of these, TB disease was diagnosed in 48 (260 cases/100,000 persons), including 11 sputum culture-positive cases (60 cases/100,000 persons), 22 sputum culture-negative cases (119 cases/100,000 persons), and 15 cases with no reported sputum-culture results (81 cases/100,000 persons). Of 21,714 persons for whom treatment for LTBI was recommended at post-arrival evaluation, 14,977 (69.0%) initiated treatment and 8,695 (40.0%) completed treatment.
Post-arrival evaluation of at-risk immigrants and refugees can be highly effective. To optimize the yield and impact of this intervention, strategies are needed to improve completion rates of post-arrival evaluation and treatment for LTBI.</description><subject>Emigrants and Immigrants</subject><subject>Humans</subject><subject>Intervention</subject><subject>Latent Tuberculosis - diagnosis</subject><subject>Latent Tuberculosis - epidemiology</subject><subject>Mass Screening</subject><subject>Noncitizens</subject><subject>Refugees</subject><subject>Tuberculosis</subject><subject>United States - epidemiology</subject><issn>2329-6933</issn><issn>2325-6621</issn><issn>2325-6621</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV1rwjAUhsPYmMP5F6Swm93U5atpcjMQ2YfgJky9DmmbaqRNXdI6_PerH5Nt5yYHznNeTngA6CM4QBEiD0NrVeGH89kAQyQgDxkm09EFuMEERyFjGF0eehEyQUgH9Lxfw7Z4hHgsrkGH4JhAKOgNeJs3iXZpU1Te-ECVlV0G7_qr2AVD58xWZ8G4LM3SKVu3Y5sFHzpvllr7wNigXulgYU3dUrNa1drfgqu8vUz3Tm8XLJ6f5qPXcDJ9GY-GkzClFNch1ySnCnMU5TkkEYSURUqlGYdZkiKokkyRPMMMYx4xhGmSJozFDCcioSRjjHTB4zF30ySlzlJta6cKuXGmVG4nK2Xk34k1K7mstpJDwVlE24D7U4CrPhvta1kan-qiUFZXjZeYYhHHAlLYonf_0HXVuL2AlmKCU0LQPpAdqdRV3judn49BUO6lybM0eZQmD9Laxf7vr5zXfhSRb30alR0</recordid><startdate>202011</startdate><enddate>202011</enddate><creator>Liu, Yecai</creator><creator>Phares, Christina R</creator><creator>Posey, Drew L</creator><creator>Maloney, Susan A</creator><creator>Cain, Kevin P</creator><creator>Weinberg, Michelle S</creator><creator>Schmit, Kristine M</creator><creator>Marano, Nina</creator><creator>Cetron, Martin S</creator><general>American Thoracic Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202011</creationdate><title>Tuberculosis among Newly Arrived Immigrants and Refugees in the United States</title><author>Liu, Yecai ; Phares, Christina R ; Posey, Drew L ; Maloney, Susan A ; Cain, Kevin P ; Weinberg, Michelle S ; Schmit, Kristine M ; Marano, Nina ; Cetron, Martin S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-8e3f4a2815ff03500465aacd80dbc10abda3fd2622856124bcb66762b9b43d663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Emigrants and Immigrants</topic><topic>Humans</topic><topic>Intervention</topic><topic>Latent Tuberculosis - diagnosis</topic><topic>Latent Tuberculosis - epidemiology</topic><topic>Mass Screening</topic><topic>Noncitizens</topic><topic>Refugees</topic><topic>Tuberculosis</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Yecai</creatorcontrib><creatorcontrib>Phares, Christina R</creatorcontrib><creatorcontrib>Posey, Drew L</creatorcontrib><creatorcontrib>Maloney, Susan A</creatorcontrib><creatorcontrib>Cain, Kevin P</creatorcontrib><creatorcontrib>Weinberg, Michelle S</creatorcontrib><creatorcontrib>Schmit, Kristine M</creatorcontrib><creatorcontrib>Marano, Nina</creatorcontrib><creatorcontrib>Cetron, Martin S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of the American Thoracic Society</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Yecai</au><au>Phares, Christina R</au><au>Posey, Drew L</au><au>Maloney, Susan A</au><au>Cain, Kevin P</au><au>Weinberg, Michelle S</au><au>Schmit, Kristine M</au><au>Marano, Nina</au><au>Cetron, Martin S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tuberculosis among Newly Arrived Immigrants and Refugees in the United States</atitle><jtitle>Annals of the American Thoracic Society</jtitle><addtitle>Ann Am Thorac Soc</addtitle><date>2020-11</date><risdate>2020</risdate><volume>17</volume><issue>11</issue><spage>1401</spage><epage>1412</epage><pages>1401-1412</pages><issn>2329-6933</issn><issn>2325-6621</issn><eissn>2325-6621</eissn><abstract>U.S. health departments routinely conduct post-arrival evaluation of immigrants and refugees at risk for tuberculosis (TB), but this important intervention has not been thoroughly studied.
To assess outcomes of the post-arrival evaluation intervention.
We categorized at-risk immigrants and refugees as having had recent completion of treatment for pulmonary TB disease overseas (including in Mexico and Canada); as having suspected TB disease (chest radiograph/clinical symptoms suggestive of TB) but negative culture results overseas; or as having latent TB infection (LTBI) diagnosed overseas. Among 2.1 million U.S.-bound immigrants and refugees screened for TB overseas during 2013-2016, 90,737 were identified as at risk for TB. We analyzed a national data set of these at-risk immigrants and refugees and calculated rates of TB disease for those who completed post-arrival evaluation.
Among 4,225 persons with recent completion of treatment for pulmonary TB disease overseas, 3,005 (71.1%) completed post-arrival evaluation within 1 year of arrival; of these, TB disease was diagnosed in 22 (732 cases/100,000 persons), including 4 sputum culture-positive cases (133 cases/100,000 persons), 13 sputum culture-negative cases (433 cases/100,000 persons), and 5 cases with no reported sputum-culture results (166 cases/100,000 persons). Among 55,938 with suspected TB disease but negative culture results overseas, 37,089 (66.3%) completed post-arrival evaluation; of these, TB disease was diagnosed in 597 (1,610 cases/100,000 persons), including 262 sputum culture-positive cases (706 cases/100,000 persons), 281 sputum culture-negative cases (758 cases/100,000 persons), and 54 cases with no reported sputum-culture results (146 cases/100,000 persons). Among 30,574 with LTBI diagnosed overseas, 18,466 (60.4%) completed post-arrival evaluation; of these, TB disease was diagnosed in 48 (260 cases/100,000 persons), including 11 sputum culture-positive cases (60 cases/100,000 persons), 22 sputum culture-negative cases (119 cases/100,000 persons), and 15 cases with no reported sputum-culture results (81 cases/100,000 persons). Of 21,714 persons for whom treatment for LTBI was recommended at post-arrival evaluation, 14,977 (69.0%) initiated treatment and 8,695 (40.0%) completed treatment.
Post-arrival evaluation of at-risk immigrants and refugees can be highly effective. To optimize the yield and impact of this intervention, strategies are needed to improve completion rates of post-arrival evaluation and treatment for LTBI.</abstract><cop>United States</cop><pub>American Thoracic Society</pub><pmid>32730094</pmid><doi>10.1513/AnnalsATS.201908-623OC</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Emigrants and Immigrants Humans Intervention Latent Tuberculosis - diagnosis Latent Tuberculosis - epidemiology Mass Screening Noncitizens Refugees Tuberculosis United States - epidemiology |
title | Tuberculosis among Newly Arrived Immigrants and Refugees in the United States |
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