Tuberculosis among Indochinese refugees in the United States

Surveys of state tuberculosis control programs revealed that of the 262,602 Indochinese refugees who entered the United States in 1979 and 1980, approximately 1.5% either had tuberculosis at the time of entry or developed it by the end of 1980; another 18% were placed on preventive therapy. The refugees comprised 5.3% of the nationally counted cases during the two-year period. Age- and sex-specific incidence rates among Indochinese refugees were 30 to 200 times higher than those for other persons in the United States. For refugees who arrived in 1979, the incidence of tuberculosis during 1980 (231 per 100,000) was only one third the incidence during 1979 (719 per 100,000). For refugees who entered the United States in 1980, the incidence during 1980 was 480 per 100,000. Bacteriologic confirmation of the diagnosis was reported for only 26% of refugees, compared with 79% of other patients with tuberculosis in the United States, suggesting overdiagnosis of tuberculosis among refugees. However, age-specific rates of bacteriologically positive tuberculosis were still 14 to 70 times higher for refugees than for the United States as a whole.