title: Civil Surgeon Tuberculosis Evaluations for Foreign-Born Persons Seeking Permanent U.S. Residence.
abstract: Foreign-born persons in the United States seeking to adjust their status to permanent resident must undergo screening for tuberculosis (TB) disease. Screening is performed by civil surgeons (CS) following technical instructions by the Centers for Disease Control and Prevention. From 2011 to 2012, 1,369 practicing CS in California, Texas, and New England were surveyed to investigate adherence to the instructions. A descriptive analysis was conducted on 907 (66%) respondents. Of 907 respondents, 739 (83%) had read the instructions and 565 (63%) understood that a chest radiograph is required for status adjustors with TB symptoms; however, only 326 (36%) knew that a chest radiograph is required for immunosuppressed status adjustors. When suspecting TB disease, 105 (12%) would neither report nor refer status adjustors to the health department; 91 (10%) would neither start treatment nor refer for TB infection. Most CS followed aspects of the technical instructions; however, educational opportunities are warranted to ensure positive patient outcomes.
authors: CDC/CSTE Applied Epidemiology Fellowship Program, Atlanta, GA, USA.|Tuberculosis Control Program, Connecticut Department of Public Health, Hartford, CT, USA.
authors: Kelley
authors: K
authors: Bemis
authors: CDC/CSTE Applied Epidemiology Fellowship Program, Atlanta, GA, USA.|Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.|County of San Diego Health and Human Services Agency, San Diego, CA, USA.
authors: Andrew
authors: A
authors: Thornton
authors: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors: Alfonso
authors: A
authors: Rodriguez-Lainz
authors: Tuberculosis Control Branch, California Department of Public Health, Richmond, CA, USA.
authors: Phil
authors: P
authors: Lowenthal
authors: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors: Miguel
authors: M
authors: Escobedo
authors: Tuberculosis Control Program, Connecticut Department of Public Health, Hartford, CT, USA.
authors: Lynn E
authors: LE
authors: Sosa
authors: Division of Tuberculosis Prevention and Control, Massachusetts Department of Public Health, Jamaica Plain, MA, USA.
authors: Andrew
authors: A
authors: Tibbs
authors: Division of Tuberculosis Prevention and Control, Massachusetts Department of Public Health, Jamaica Plain, MA, USA.
authors: Sharon
authors: S
authors: Sharnprapai
authors: County of San Diego Health and Human Services Agency, San Diego, CA, USA.
authors: Kathleen S
authors: KS
authors: Moser
authors: Division of Tuberculosis Prevention and Control, Massachusetts Department of Public Health, Jamaica Plain, MA, USA.
authors: Jennifer
authors: J
authors: Cochran
authors: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, 1600 Clifton Rd. Mailstop E-10, Atlanta, GA, 30333, USA. Mark.Lobato@ct.gov.
authors: Mark N
authors: MN
authors: Lobato
mesh_terms: D002140:California; D002487:Centers for Disease Control and Prevention, U.S. / Q000592:standards; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D004641:Emigration and Immigration / Q000331:legislation & jurisprudence*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D038622:Internationality; D008297:Male; D008403:Mass Screening / Q000592:standards*; D009511:New England; D011634:Public Health / Q000592:standards*; D066231:Surgeons / Q000592:standards*; D011795:Surveys and Questionnaires; D013781:Texas; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology; D014481:United States
keywords: Immigration; Public health; Screening; Surveillance; Tuberculosis