title: Postarrival Tuberculosis Screening of High-Risk Immigrants at a Local Health Department.
abstract: OBJECTIVE
  We sought to characterize postimmigration tuberculosis (TB) care for Class B immigrants and refugees at the Baltimore City Health Department TB program (BCHD), and to determine the proportion of immigrants with active TB or latent TB infection (LTBI) in this high-risk population.
  
  
  METHODS
  We conducted a retrospective chart review of Class B immigrants and refugees who reported to the BCHD for postimmigration TB evaluation from 2010 to 2012.
  
  
  RESULTS
  We reviewed the clinical records of 153 Class B immigrants; 4% were diagnosed with active TB and 53% were diagnosed with LTBI. Fifty percent of active TB cases were culture positive, and 67% were asymptomatic; 100% received and completed active TB therapy at the BCHD. Among those diagnosed with LTBI, 87% initiated LTBI therapy and 91% completed treatment.
  
  
  CONCLUSIONS
  The high prevalence of active TB and LTBI found among Class B immigrants underscore the importance for postarrival TB screening. The absence of reported symptoms among the majority of active cases identified during this study suggest that reliance on symptom-based screening protocols to prompt sputa testing may be inadequate for identifying active TB among this high-risk group.
authors.affiliation: Jennifer B. Nuzzo and Patrick Chaulk are with the School of Public Health, Johns Hopkins University, Baltimore, MD. Jennifer B. Nuzzo is also with the UPMC Center for Health Security, Baltimore. Jonathan E. Golub, Patrick Chaulk, and Maunank Shah are with the School of Medicine, Johns Hopkins University, Baltimore. Patrick Chaulk is also with the Baltimore City Health Department, Baltimore.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Nuzzo
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Golub
authors.forename: Patrick
authors.initials: P
authors.lastname: Chaulk
authors.forename: Maunank
authors.initials: M
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D000328:Adult; D015142:Baltimore / 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 / Q000706:statistics & numerical data; D008875:Middle Aged; D012036:Refugees / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult