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Tuberculosis among immigrants and refugees

K DeRiemer1, D P Chin, G F Schecter

  • 1Division of Public Health Biology and Epidemiology, School of Public Health, University of California at Berkeley, 94720-7360, USA.

Archives of Internal Medicine
|April 29, 1998
PubMed
Summary

Timely medical evaluation for immigrants and refugees is crucial for tuberculosis (TB) prevention. Overseas screening identifies high-risk individuals, but follow-up after arrival significantly improves TB detection and control.

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Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Immigration Health

Background:

  • Overseas screening identifies immigrants and refugees at high risk for tuberculosis (TB).
  • Effectiveness of TB control relies on post-arrival medical evaluation and follow-up.
  • Immigrant and refugee health is a key component of public health initiatives.

Purpose of the Study:

  • To evaluate the effectiveness of the US overseas TB screening program.
  • To determine the yield of active and preventable TB cases from follow-up evaluations.
  • To identify predictors of seeking medical evaluation and TB diagnosis in immigrants and refugees.

Main Methods:

  • Retrospective cohort study of 893 immigrants and refugees arriving in San Francisco.
  • Analysis of time to report for medical evaluation post-arrival.

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  • Assessment of TB diagnosis and need for preventive therapy.

    • Main Results:

    • Median time to seek care was 9 days; 83.4% sought further evaluation.
    • Active TB found in 6.9%, with 39.7% eligible for preventive therapy.
    • Refugee status predicted failure to seek care; Class B-1 status and origin from China predicted TB diagnosis.

    Conclusions:

    • Timely and adequate medical evaluation of immigrants and refugees is essential for TB control.
    • Follow-up care for this population has a high yield for identifying TB cases.
    • Prioritizing TB prevention and control programs for immigrants and refugees is recommended.