title: Missed opportunities to prevent tuberculosis in foreign-born persons, Connecticut, 2005-2008.
abstract: METHODS
  Factors that influence testing for latent tuberculosis infection (LTBI) among foreign-born persons in Connecticut are not well understood.
  
  
  OBJECTIVE
  To identify predictors for LTBI testing and challenges related to accessing health care among the foreign-born population in Connecticut.
  
  
  METHODS
  Foreign-born Connecticut residents with confirmed or suspected tuberculosis (TB) disease during June 2005-December 2008 were interviewed regarding health care access and immigration status. Predictors for self-reported testing for LTBI after US entry were determined.
  
  
  RESULTS
  Of 161 foreign-born persons interviewed, 48% experienced TB disease within 5 years after arrival. One third (51/156) reported having undergone post-arrival testing for LTBI. Although those with established health care providers were more likely to have reported testing (aOR 4.49, 95%CI 1.48-13.62), only 43% of such persons were tested. Undocumented persons, the majority of whom lacked a provider (53%), were less likely than documented persons to have reported testing (aOR 0.20, 95%CI 0.06-0.67). Hispanic permanent residents (immigrants and refugees) and visitors (persons admitted temporarily) were more likely than non-Hispanics in the respective groups to have reported testing (OR 5.25, 95%CI 1.51-18.31 and OR 7.08, 95%CI 1.30-38.44, respectively).
  
  
  CONCLUSIONS
  The self-reported rate of testing for LTBI among foreign-born persons in Connecticut with confirmed or suspected TB was low and differed significantly by ethnicity and immigration status. Strategies are needed to improve health care access for foreign-born persons and expand testing for LTBI, especially among non-Hispanic and undocumented populations.
authors: Centers for Disease Control and Prevention, Atlanta, GA, USA. ggt4@cdc.gov
authors: A
authors: A
authors: Guh
authors: L
authors: L
authors: Sosa
authors: J L
authors: JL
authors: Hadler
authors: M N
authors: MN
authors: Lobato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000706:statistics & numerical data*; D003237:Connecticut / Q000453:epidemiology; D018563:Disease Notification; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D011634:Public Health / Q000706:statistics & numerical data; D057566:Self Report; D013997:Time Factors; D035862:Vulnerable Populations / Q000208:ethnology*; D055815:Young Adult