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Tuberculosis among foreign-born persons in New York City, 1992-1994: implications for tuberculosis control
N G Tornieporth1, Y Ptachewich, N Poltoratskaia
1Department of Medicine, Cornell University Medical College, New York, New York, USA.
Summary
Most tuberculosis (TB) in foreign-born New Yorkers reactivates from prior infections. However, new TB infections in this group are acquired from strains circulating among US-born patients, with similar risk factors.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Tuberculosis (TB) remains a significant global health concern.
- Understanding transmission patterns is crucial for effective control strategies, especially in diverse urban populations.
Purpose of the Study:
- To investigate the transmission patterns of tuberculosis (TB) among foreign-born individuals residing in New York City.
- To compare TB transmission in foreign-born versus US-born populations.
Main Methods:
- A retrospective multicenter study was conducted from 1992-1994.
- Compared 158 foreign-born TB patients with 231 US-born TB patients.
- Analyzed Mycobacterium tuberculosis DNA fingerprint patterns to assess transmission.
Main Results:
- Foreign-born TB patients showed significantly lower rates of recent exogenous transmission (16%) compared to US-born patients (42%).
- Identical TB strains were found in both foreign-born and US-born cases, indicating shared transmission networks.
- Increased duration of residence, homelessness, and multidrug-resistant TB were associated with new TB infections in foreign-born individuals.
Conclusions:
- The majority of TB cases in foreign-born individuals in NYC result from reactivation of latent infections acquired abroad.
- New TB infections acquired in NYC by foreign-born individuals involve strains already circulating within the US-born population.
- Risk factors for acquiring new TB infections in foreign-born individuals are similar to those in US-born patients.
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