title: Latent tuberculosis infection screening in foreign-born populations: a successful mobile clinic outreach model.
abstract: OBJECTIVE
  We evaluated the efficacy of a mobile medical clinic (MMC) screening program for detecting latent tuberculosis infection (LTBI) and active tuberculosis.
  
  
  METHODS
  A LTBI screening program in a MMC in New Haven, Connecticut, used medical surveys to examine risk factors and tuberculin skin test (TST) screening eligibility. We assessed clinically relevant correlates of total (prevalent; n = 4650) and newly diagnosed (incident; n = 4159) LTBI from 2003 to 2011.
  
  
  RESULTS
  Among 8322 individuals, 4159 (55.6%) met TST screening eligibility criteria, of which 1325 (31.9%) had TST assessed. Similar to LTBI prevalence (16.8%; 779 of 4650), newly diagnosed LTBI (25.6%; 339 of 1325) was independently correlated with being foreign-born (adjusted odds ratio [AOR] = 8.49; 95% confidence interval [CI] = 5.54, 13.02), Hispanic (AOR = 3.12; 95% CI = 1.88, 5.20), Black (AOR = 2.16; 95% CI = 1.31, 3.55), employed (AOR = 1.61; 95% CI = 1.14, 2.28), and of increased age (AOR = 1.04; 95% CI = 1.02, 1.05). Unstable housing (AOR = 4.95; 95% CI = 3.43, 7.14) and marijuana use (AOR = 1.57; 95% CI = 1.05, 2.37) were significantly correlated with incident LTBI, and being male, heroin use, interpersonal violence, employment, not having health insurance, and not completing high school were significantly correlated with prevalent LTBI.
  
  
  CONCLUSIONS
  Screening for TST in MMCs successfully identifies high-risk foreign-born, Hispanic, working, and uninsured populations and innovatively identifies LTBI in urban settings.
authors.affiliation: Jamie P. Morano, Alexei Zelenev, Mary R. Walton, R. Douglas Bruce, and Frederick L. Altice are with the Yale School of Medicine, Department of Infectious Diseases, Yale University AIDS Program, New Haven, CT. R. D. Bruce and F. L. Altice are also affiliated with the Yale School of Public Health, Division of Epidemiology of Microbial Diseases, New Haven. F. L. Altice is also associated with the Centre of Excellence in Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Jamie P
authors.initials: JP
authors.lastname: Morano
authors.forename: Alexei
authors.initials: A
authors.lastname: Zelenev
authors.forename: Mary R
authors.initials: MR
authors.lastname: Walton
authors.forename: R Douglas
authors.initials: RD
authors.lastname: Bruce
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
mesh_terms: D000328:Adult; D003237:Connecticut / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008952:Mobile Health Units / Q000458:organization & administration*; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D014374:Tuberculin Test / Q000379:methods