title: Tuberculosis prevention among foreign-born persons in Seattle--King County, Washington.
abstract: The purpose of this study was to evaluate the outcomes of classified immigrant and refugee (I&R) screening and of contact investigation (CI) of foreign-born TB cases in Seattle--King County (SKC), Washington. We reviewed I&R evaluations from the SKC TB clinic for 1992-1994 and contact evaluation records for 54 randomly selected U.S.-born and foreign-born pulmonary TB patients from 1993. Among 942 I&R evaluated, 693 (74%) had positive tuberculin skin tests (TST). Preventive therapy (PT) was prescribed for 324 (34%) and treatment for 49 (5%). The remaining 377 were dismissed, of whom 96% did not meet American Thoracic Society PT criteria. Contacts of foreign-born cases were more numerous (6.0 versus 3.4 per case, p = 0.04), and significantly more likely to be TST-positive (50% versus 18%) and to be started on PT (40% versus 23%). The large number of I&R eligible for treatment or PT emphasizes the benefit of prompt evaluation of new arrivals. CI provides an excellent opportunity to screen foreign-born persons at high risk for active TB.
authors.affiliation: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: C D
authors.initials: CD
authors.lastname: Wells
authors.forename: P L
authors.initials: PL
authors.lastname: Zuber
authors.forename: C M
authors.initials: CM
authors.lastname: Nolan
authors.forename: N J
authors.initials: NJ
authors.lastname: Binkin
authors.forename: S V
authors.initials: SV
authors.lastname: Goldberg
mesh_terms: D016358:Contact Tracing / Q000706:statistics & numerical data; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D006801:Humans; D008400:Mass Chest X-Ray / Q000706:statistics & numerical data; D011897:Random Allocation; D012036:Refugees / Q000706:statistics & numerical data; D014374:Tuberculin Test / Q000706:statistics & numerical data; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D014505:Urban Population / Q000706:statistics & numerical data; D014861:Washington / Q000453:epidemiology