title: Impact of port of entry referrals on initiation of follow-up evaluations for immigrants with suspected tuberculosis: Illinois.
abstract: US-bound immigrants with suspected non-infectious TB are encouraged to be medically re-evaluated after arrival in the United States. We evaluated the Centers for Disease Control and Prevention's immigrant referral process, designed to facilitate timely post-arrival evaluations. Over 1,200 immigrants with suspected TB arriving during October 1, 2008-September 30, 2010 were identified. In 2011, differences in days to evaluation initiation were assessed by referral type using survival analysis and Cox proportional hazard models. Among those receiving any referral, median time to post-arrival evaluation was significantly lower compared with immigrants receiving no referral (16 vs. 69 days, respectively; p < 0.0001). After adjusting for the covariates, immigrants receiving any referral initiated follow-up at 4 times the rate (adjusted hazard ratio = 4.0; p < 0.0001) of those receiving no referral. Implementing a referral system at US ports of entry will improve timeliness and increase the proportion of immigrants initiating domestic evaluation.
authors: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop C-01, Atlanta, GA 30333, USA. kby5@cdc.gov
authors: Teal R
authors: TR
authors: Bell
authors: NoelleAngelique M
authors: NM
authors: Molinari
authors: Sena
authors: S
authors: Blumensaadt
authors: Monica U
authors: MU
authors: Selent
authors: Michael
authors: M
authors: Arbisi
authors: Neha
authors: N
authors: Shah
authors: Demian
authors: D
authors: Christiansen
authors: Rossanne
authors: R
authors: Philen
authors: Benjamin
authors: B
authors: Puesta
authors: Joshua
authors: J
authors: Jones
authors: Deborah
authors: D
authors: Lee
authors: Arnold
authors: A
authors: Vang
authors: Nicole J
authors: NJ
authors: Cohen
mesh_terms: D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007087:Illinois; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D016019:Survival Analysis; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000208:ethnology*; D014481:United States; D055815:Young Adult
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