Tuberculosis among immigrants and refugees

Kathryn DeRiemer, Daniel P. Chin, Gisela F. Schecter, Arthur L. Reingold

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Background: Overseas screening of immigrants and refugees applying for a visa to the United States identities foreign-born individuals who are at high risk for tuberculosis (TB) or who have active TB. The system's effectiveness relies on further medical evaluation and follow-up of foreign-born individuals after their arrival in the United States. Methods: Retrospective cohort study of 893 immigrants and refugees who arrived in the United States from July 1, 1992, through December 31, 1993, with a destination of San Francisco, Calif, and a referral for further medical evaluation. Main Outcome Measures: Time to report to the local health department after arrival and the yield of active and preventable cases of TB from follow-up medical evaluations. Results: Median time from arrival in the United States to seeking care in San Francisco was 9 days (range, 1-920 days). Of 745 immigrants and refugees (83.4%) who sought further medical evaluation, 51 (6.9%) had active TB and 296 (39.7%) were candidates for preventive therapy. Being a refugee was an independent predictor of failure to seek further medical evaluation in the United States. Class B-1 disease status based on overseas TB screening (odds ratio, 3.5; 95% confidence interval, 2.0-6.2) and being from mainland China (odds ratio, 4.4; 95% confidence interval, 1.9- 9.9) were independent predictors of TB diagnosed in San Francisco. Conclusions: Timely, adequate medical evaluation and follow-up care of immigrants and refugees has a relatively high yield and should be a high priority for TB prevention and control programs.

Original languageEnglish (US)
Pages (from-to)753-760
Number of pages8
JournalArchives of Internal Medicine
Volume158
Issue number7
DOIs
StatePublished - Apr 13 1998

Fingerprint

Refugees
Tuberculosis
San Francisco
Odds Ratio
Confidence Intervals
Aftercare
China
Cohort Studies
Referral and Consultation
Retrospective Studies
Outcome Assessment (Health Care)
Health

ASJC Scopus subject areas

  • Internal Medicine

Cite this

DeRiemer, K., Chin, D. P., Schecter, G. F., & Reingold, A. L. (1998). Tuberculosis among immigrants and refugees. Archives of Internal Medicine, 158(7), 753-760. https://doi.org/10.1001/archinte.158.7.753

Tuberculosis among immigrants and refugees. / DeRiemer, Kathryn; Chin, Daniel P.; Schecter, Gisela F.; Reingold, Arthur L.

In: Archives of Internal Medicine, Vol. 158, No. 7, 13.04.1998, p. 753-760.

Research output: Contribution to journalArticle

DeRiemer, K, Chin, DP, Schecter, GF & Reingold, AL 1998, 'Tuberculosis among immigrants and refugees', Archives of Internal Medicine, vol. 158, no. 7, pp. 753-760. https://doi.org/10.1001/archinte.158.7.753
DeRiemer K, Chin DP, Schecter GF, Reingold AL. Tuberculosis among immigrants and refugees. Archives of Internal Medicine. 1998 Apr 13;158(7):753-760. https://doi.org/10.1001/archinte.158.7.753
DeRiemer, Kathryn ; Chin, Daniel P. ; Schecter, Gisela F. ; Reingold, Arthur L. / Tuberculosis among immigrants and refugees. In: Archives of Internal Medicine. 1998 ; Vol. 158, No. 7. pp. 753-760.
@article{56da3a2b18b948da9ea26d64ce3a9570,
title = "Tuberculosis among immigrants and refugees",
abstract = "Background: Overseas screening of immigrants and refugees applying for a visa to the United States identities foreign-born individuals who are at high risk for tuberculosis (TB) or who have active TB. The system's effectiveness relies on further medical evaluation and follow-up of foreign-born individuals after their arrival in the United States. Methods: Retrospective cohort study of 893 immigrants and refugees who arrived in the United States from July 1, 1992, through December 31, 1993, with a destination of San Francisco, Calif, and a referral for further medical evaluation. Main Outcome Measures: Time to report to the local health department after arrival and the yield of active and preventable cases of TB from follow-up medical evaluations. Results: Median time from arrival in the United States to seeking care in San Francisco was 9 days (range, 1-920 days). Of 745 immigrants and refugees (83.4{\%}) who sought further medical evaluation, 51 (6.9{\%}) had active TB and 296 (39.7{\%}) were candidates for preventive therapy. Being a refugee was an independent predictor of failure to seek further medical evaluation in the United States. Class B-1 disease status based on overseas TB screening (odds ratio, 3.5; 95{\%} confidence interval, 2.0-6.2) and being from mainland China (odds ratio, 4.4; 95{\%} confidence interval, 1.9- 9.9) were independent predictors of TB diagnosed in San Francisco. Conclusions: Timely, adequate medical evaluation and follow-up care of immigrants and refugees has a relatively high yield and should be a high priority for TB prevention and control programs.",
author = "Kathryn DeRiemer and Chin, {Daniel P.} and Schecter, {Gisela F.} and Reingold, {Arthur L.}",
year = "1998",
month = "4",
day = "13",
doi = "10.1001/archinte.158.7.753",
language = "English (US)",
volume = "158",
pages = "753--760",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "7",

}

TY - JOUR

T1 - Tuberculosis among immigrants and refugees

AU - DeRiemer, Kathryn

AU - Chin, Daniel P.

AU - Schecter, Gisela F.

AU - Reingold, Arthur L.

PY - 1998/4/13

Y1 - 1998/4/13

N2 - Background: Overseas screening of immigrants and refugees applying for a visa to the United States identities foreign-born individuals who are at high risk for tuberculosis (TB) or who have active TB. The system's effectiveness relies on further medical evaluation and follow-up of foreign-born individuals after their arrival in the United States. Methods: Retrospective cohort study of 893 immigrants and refugees who arrived in the United States from July 1, 1992, through December 31, 1993, with a destination of San Francisco, Calif, and a referral for further medical evaluation. Main Outcome Measures: Time to report to the local health department after arrival and the yield of active and preventable cases of TB from follow-up medical evaluations. Results: Median time from arrival in the United States to seeking care in San Francisco was 9 days (range, 1-920 days). Of 745 immigrants and refugees (83.4%) who sought further medical evaluation, 51 (6.9%) had active TB and 296 (39.7%) were candidates for preventive therapy. Being a refugee was an independent predictor of failure to seek further medical evaluation in the United States. Class B-1 disease status based on overseas TB screening (odds ratio, 3.5; 95% confidence interval, 2.0-6.2) and being from mainland China (odds ratio, 4.4; 95% confidence interval, 1.9- 9.9) were independent predictors of TB diagnosed in San Francisco. Conclusions: Timely, adequate medical evaluation and follow-up care of immigrants and refugees has a relatively high yield and should be a high priority for TB prevention and control programs.

AB - Background: Overseas screening of immigrants and refugees applying for a visa to the United States identities foreign-born individuals who are at high risk for tuberculosis (TB) or who have active TB. The system's effectiveness relies on further medical evaluation and follow-up of foreign-born individuals after their arrival in the United States. Methods: Retrospective cohort study of 893 immigrants and refugees who arrived in the United States from July 1, 1992, through December 31, 1993, with a destination of San Francisco, Calif, and a referral for further medical evaluation. Main Outcome Measures: Time to report to the local health department after arrival and the yield of active and preventable cases of TB from follow-up medical evaluations. Results: Median time from arrival in the United States to seeking care in San Francisco was 9 days (range, 1-920 days). Of 745 immigrants and refugees (83.4%) who sought further medical evaluation, 51 (6.9%) had active TB and 296 (39.7%) were candidates for preventive therapy. Being a refugee was an independent predictor of failure to seek further medical evaluation in the United States. Class B-1 disease status based on overseas TB screening (odds ratio, 3.5; 95% confidence interval, 2.0-6.2) and being from mainland China (odds ratio, 4.4; 95% confidence interval, 1.9- 9.9) were independent predictors of TB diagnosed in San Francisco. Conclusions: Timely, adequate medical evaluation and follow-up care of immigrants and refugees has a relatively high yield and should be a high priority for TB prevention and control programs.

UR - http://www.scopus.com/inward/record.url?scp=0032513498&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032513498&partnerID=8YFLogxK

U2 - 10.1001/archinte.158.7.753

DO - 10.1001/archinte.158.7.753

M3 - Article

VL - 158

SP - 753

EP - 760

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 7

ER -