Screening of immigrants and refugees for pulmonary tuberculosis in San Diego County, California.
OBJECTIVE
To evaluate the outcomes of a tuberculosis (TB) screening program for recent immigrants to San Diego County, CA, and to compare the demographic and clinical characteristics of pulmonary TB cases occurring in recently arrived foreign-born persons detected through this screening with those of similar cases found through routine surveillance.


METHODS
Retrospective review of computer databases and medical records.


METHODS
Local public health department.


METHODS
Recent immigrants and refugees classified as TB suspects in their country of departure and foreign-born patients with active TB detected through routine surveillance.


RESULTS
Five hundred seventy-one of 658 immigrants and refugees (87%) of completed screening. Thirty-nine subjects (7%) were found to have active TB, and 433 subjects (76%) were found to have latent TB. A diagnosis of active TB was associated with age of 25 to 44 years (odds ratio, 3.6; 95% confidence interval, 1.1 to 11.6) and A (odds ratio, 25.7; 95% confidence interval, 1.3 to 512.2) or B1 classifications (odds ratio, 4.3; 95% confidence interval, 1.5 to 12.5). Cases detected through screening comprised 12% of all reported foreign-born persons with active TB. Compared to other recently arrived foreign-born persons with active TB, those detected through immigrant screening were more likely to be Asian and born in the Philippines and less likely to have advanced disease.


CONCLUSIONS
Most immigrants and refugees classified as TB suspects by foreign screening completed the US screening process, which had a high yield for detecting active and latent TB. Only a minority of foreign-born persons (12%) with active TB were discovered through this program, however, and additional measures are needed to facilitate early case finding in other foreign-born populations.
LoBue
Philip A
PA
Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention, Division of Tuberculosis Elimination, Field Services and Evaluation Branch, Mail Stop E-10, 1600 Clifton Road, Atlanta, GA 30333, USA. pgl5@cdc.gov
Moser
Kathleen S
KS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D002140:California; D002648:Child; D002675:Child, Preschool; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D016017:Odds Ratio; D010679:Philippines / Q000208:ethnology; D012036:Refugees; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*