Tuberculosis among foreign-born persons in Los Angeles County, 1992-1994

To describe the epidemiology of foreign-born tuberculosis (TB) cases in Los Angeles County and to evaluate current TB screening and follow-up of immigrants and refugees (I&R) to the USA.

Retrospective analysis of the Los Angeles County TB registry between October 1992 and December 1994. We matched all cases who entered the USA during fiscal year 1993 (FY93) with a database from the tracking system of I&R with suspected TB.

Foreign-born persons accounted for 64% of all reported TB cases. Half were born in Mexico or Central America. Standardized incidence rates were 3-5 times higher than those of US-born persons for Mexicans and Central Americans, 6-7 times higher for North-east Asians, and 10-15 times higher for South-east Asians. Among foreign-born cases who arrived during FY93, 5% of the Mexicans and Central Americans, 48% of the North-east Asians and 67% of the South-east Asians were registered by the tracking system.

Mexicans and Central Americans accounted for the majority of cases but had a lower incidence of TB than Asians. The current screening procedures identify a large proportion of cases among recently arrived South-east Asians, but contribute little to the control of TB among Mexicans and Central Americans.