title: Multidrug-resistant tuberculosis among patients in Baja California, Mexico, and Hispanic patients in California.
abstract: OBJECTIVE
  We sought to compare prevalence and determinants of multidrug-resistant tuberculosis (MDR-TB) between tuberculosis patients in Baja California, Mexico, and Hispanic patients in California.
  
  
  METHODS
  Using data from Mexico's National TB Drug Resistance Survey (2008-2009) and California Department of Public Health TB case registry (2004-2009), we assessed differences in MDR-TB prevalence comparing (1) Mexicans in Baja California, (2) Mexico-born Hispanics in California, (3) US-born Hispanics in California, and (4) California Hispanics born elsewhere.
  
  
  RESULTS
  MDR-TB prevalence was 2.1% in Baja California patients, 1.6% in Mexico-born California patients, 0.4% in US-born California patients, and 2.7% in Hispanic California patients born elsewhere. In multivariate analysis, previous antituberculosis treatment was associated with MDR-TB (odds ratio [OR] = 6.57; 95% confidence interval [CI] = 3.34, 12.96); Mexico-born TB patients in California (OR = 5.08; 95% CI = 1.19, 21.75) and those born elsewhere (OR = 7.69; 95% CI = 1.71, 34.67) had greater odds of MDR-TB compared with US-born patients (reference category).
  
  
  CONCLUSIONS
  Hispanic patients born outside the US or Mexico were more likely to have MDR-TB than were those born within these countries. Possible explanations include different levels of exposure to resistant strains and inadequate treatment.
authors.affiliation: Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, Mexico.
authors.forename: Ietza
authors.initials: I
authors.lastname: Bojorquez
authors.forename: Richard F W
authors.initials: RF
authors.lastname: Barnes
authors.forename: Jennifer
authors.initials: J
authors.lastname: Flood
authors.forename: Hugo
authors.initials: H
authors.lastname: López-Gatell
authors.forename: Richard S
authors.initials: RS
authors.lastname: Garfein
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Bäcker
authors.forename: Celia
authors.initials: C
authors.lastname: Alpuche
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Vinetz
authors.forename: Antonino
authors.initials: A
authors.lastname: Catanzaro
authors.forename: Midori
authors.initials: M
authors.lastname: Kato-Maeda
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Rodwell
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002140:California / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D016017:Odds Ratio; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000208:ethnology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents