Missed opportunities to prevent tuberculosis in foreign-born persons, Connecticut, 2005-2008

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Services Research

Background:

• Latent tuberculosis infection (LTBI) testing rates and influencing factors among foreign-born populations in Connecticut are not well understood.
• Foreign-born individuals are at increased risk for tuberculosis (TB) disease, necessitating effective screening strategies.
• Access to healthcare services presents a significant challenge for foreign-born residents in Connecticut.

Purpose of the Study:

• To identify predictors of LTBI testing among foreign-born individuals in Connecticut.
• To explore challenges related to healthcare access for the foreign-born population.
• To inform strategies for improving LTBI screening in this demographic.

Main Methods:

• A study involving foreign-born Connecticut residents diagnosed with confirmed or suspected TB between June 2005 and December 2008.
• Interviews were conducted to gather data on healthcare access, immigration status, and self-reported LTBI testing post-US entry.
• Statistical analysis was performed to determine predictors of LTBI testing.

Main Results:

• Nearly half (48%) of interviewed foreign-born individuals experienced TB disease within five years of arrival.
• Only one-third (51/156) reported post-arrival LTBI testing; having a healthcare provider increased reported testing likelihood (aOR 4.49).
• Undocumented individuals and non-Hispanic groups were less likely to report LTBI testing compared to documented and Hispanic individuals, respectively.

Conclusions:

• The self-reported rate of LTBI testing among foreign-born individuals with TB in Connecticut was low and varied significantly by ethnicity and immigration status.
• Strategies to enhance healthcare access for foreign-born persons are crucial for increasing LTBI testing.
• Targeted interventions are needed to expand LTBI testing, especially among non-Hispanic and undocumented populations.