Risk factors for drug-resistant tuberculosis among non-US-born persons in New York City.
METHODS
New York City (NYC).


OBJECTIVE
To examine the extent to which prior tuberculosis (TB) treatment, length of residence in the United States and other factors are associated with the occurrence of drug resistance among non-US-born persons in NYC.


METHODS
Cases were non-US-born persons diagnosed with TB in NYC from 1998-1999 and from 2001-2002, with an initial Mycobacterium tuberculosis isolate resistant to any first-line anti-tuberculosis drug. Controls were randomly selected from non-US-born persons whose isolates were susceptible to all first-line anti-tuberculosis drugs.


RESULTS
Overall, cases with multidrug-resistant (MDR) TB were more likely to have had prior TB treatment; other drug resistance was not associated with prior TB treatment. In a multivariate model, the relationship between MDR-TB and prior treatment remained significant for non-US-born persons regardless of length of time in the U.S.


CONCLUSIONS
The findings underscore the utility of monitoring trends in drug resistance among the non-US-born by time in the US and prior treatment to determine where or when drug resistance may be occurring.
Clark
C M
CM
Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, New York, New York 10007, USA. cclark@health.nyc.gov
Li
J
J
Driver
C R
CR
Munsiff
S S
SS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*
D000995:Antitubercular Agents