Influences of cross-border mobility on tuberculosis diagnoses and treatment interruption among injection drug users in Tijuana, Mexico.
OBJECTIVE
We sought to identify correlates of reported lifetime diagnoses of TB among injection drug users in the border city of Tijuana, Mexico.


METHODS
Injection drug users in Tijuana were recruited into a prospective cohort study during 2006 and 2007. We used weighted multivariate logistic regression to identify correlates of TB diagnoses.


RESULTS
Of the 1056 participants, 103 (9.8%) reported a history of TB, among whom 93% received anti-TB medication and 80% were diagnosed in the United States. Treatment was prematurely halted among 8% of patients; deportation from the United States was the cause of half of these treatment interruptions. History of travel to (odds ratio [OR] = 6.44; 95% confidence interval [CI] = 1.53, 27.20) or deportation from (OR = 1.83; 95% CI = 1.07, 3.12) the United States and incarceration (OR = 2.20; 95% CI = 1.06, 4.58) were independently associated with a reported lifetime diagnosis of TB.


CONCLUSIONS
Mobility and migration are important factors in identifying and treating TB patients diagnosed in the US-Mexico border region. Strengthening capacity on both sides of the border to identify, monitor, and treat TB is a priority.
Deiss
Robert
R
Department of Family and Preventive Medicine, Division of International Health and Cross-Cultural Medicine, School of Medicine, University of California, San Diego, USA.
Garfein
Richard S
RS
Lozada
Remedios
R
Burgos
Jose Luis
JL
Brouwer
Kimberly C
KC
Moser
Kathleen S
KS
Zuniga
Maria Luisa
ML
Rodwell
Timothy C
TC
Ojeda
Victoria D
VD
Strathdee
Steffanie A
SA
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002391:Catchment Area, Health; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000208:ethnology; D011157:Population Dynamics / Q000706:statistics & numerical data* / Q000639:trends*; D015995:Prevalence; D011446:Prospective Studies; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D028761:Withholding Treatment / Q000706:statistics & numerical data*
D000995:Antitubercular Agents