title: Preventing Infectious Pulmonary Tuberculosis Among Foreign-Born Residents of the United States.
abstract: OBJECTIVE
  We described risk factors associated with infectious tuberculosis (TB) and missed TB-prevention opportunities in foreign-born US residents, who account for almost two thirds of the nation's TB patients.
  
  
  METHODS
  In a cross-sectional study at 20 US sites of foreign-born persons diagnosed with TB in 2005 through 2006, we collected results of sputum smear microscopy for acid-fast bacilli (a marker for infectiousness) and data on visa status, sociodemographics, TB-related care seeking, and latent TB infection (LTBI) diagnosis opportunities.
  
  
  RESULTS
  Among 980 persons with pulmonary TB who reported their visa status, 601 (61%) were legal permanent residents, 131 (13.4%) had temporary visas, and 248 (25.3%) were undocumented. Undocumented persons were more likely than permanent residents to have acid-fast bacilli-positive smears at diagnosis (risk ratio = 1.3; 95% confidence interval = 1.2, 1.4). Of those diagnosed 1 year or more after arrival, 57.3% reported LTBI screening opportunities; fewer than 25% actually were. Undocumented persons reported fewer LTBI screening opportunities and were less likely to be tested.
  
  
  CONCLUSIONS
  Progress toward TB elimination in the United States depends upon expanding opportunities for regular medical care and promotion of LTBI screening and treatment among foreign-born persons.
authors.affiliation: Amy L. Davidow is with Rutgers Biological and Health Sciences, New Jersey Medical School, Department of Preventive Medicine and Community Health, Newark. Dolly Katz and Smita Ghosh are with Centers for Disease Control and Prevention, Division of TB Elimination, Atlanta, GA. Henry Blumberg is with Emory University School of Medicine, Department of Medicine, Atlanta. Ashutosh Tamhane is with University of Alabama at Birmingham, Department of Medicine. Anna Sevilla is with Global TB Institute, Rutgers Biological and Health Sciences. Randall Reves is with Denver Health and Hospitals Authority, Denver, CO.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Davidow
authors.affiliation: Amy L. Davidow is with Rutgers Biological and Health Sciences, New Jersey Medical School, Department of Preventive Medicine and Community Health, Newark. Dolly Katz and Smita Ghosh are with Centers for Disease Control and Prevention, Division of TB Elimination, Atlanta, GA. Henry Blumberg is with Emory University School of Medicine, Department of Medicine, Atlanta. Ashutosh Tamhane is with University of Alabama at Birmingham, Department of Medicine. Anna Sevilla is with Global TB Institute, Rutgers Biological and Health Sciences. Randall Reves is with Denver Health and Hospitals Authority, Denver, CO.
authors.forename: Dolly
authors.initials: D
authors.lastname: Katz
authors.affiliation: Amy L. Davidow is with Rutgers Biological and Health Sciences, New Jersey Medical School, Department of Preventive Medicine and Community Health, Newark. Dolly Katz and Smita Ghosh are with Centers for Disease Control and Prevention, Division of TB Elimination, Atlanta, GA. Henry Blumberg is with Emory University School of Medicine, Department of Medicine, Atlanta. Ashutosh Tamhane is with University of Alabama at Birmingham, Department of Medicine. Anna Sevilla is with Global TB Institute, Rutgers Biological and Health Sciences. Randall Reves is with Denver Health and Hospitals Authority, Denver, CO.
authors.forename: Smita
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Amy L. Davidow is with Rutgers Biological and Health Sciences, New Jersey Medical School, Department of Preventive Medicine and Community Health, Newark. Dolly Katz and Smita Ghosh are with Centers for Disease Control and Prevention, Division of TB Elimination, Atlanta, GA. Henry Blumberg is with Emory University School of Medicine, Department of Medicine, Atlanta. Ashutosh Tamhane is with University of Alabama at Birmingham, Department of Medicine. Anna Sevilla is with Global TB Institute, Rutgers Biological and Health Sciences. Randall Reves is with Denver Health and Hospitals Authority, Denver, CO.
authors.forename: Henry
authors.initials: H
authors.lastname: Blumberg
authors.affiliation: Amy L. Davidow is with Rutgers Biological and Health Sciences, New Jersey Medical School, Department of Preventive Medicine and Community Health, Newark. Dolly Katz and Smita Ghosh are with Centers for Disease Control and Prevention, Division of TB Elimination, Atlanta, GA. Henry Blumberg is with Emory University School of Medicine, Department of Medicine, Atlanta. Ashutosh Tamhane is with University of Alabama at Birmingham, Department of Medicine. Anna Sevilla is with Global TB Institute, Rutgers Biological and Health Sciences. Randall Reves is with Denver Health and Hospitals Authority, Denver, CO.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Tamhane
authors.affiliation: Amy L. Davidow is with Rutgers Biological and Health Sciences, New Jersey Medical School, Department of Preventive Medicine and Community Health, Newark. Dolly Katz and Smita Ghosh are with Centers for Disease Control and Prevention, Division of TB Elimination, Atlanta, GA. Henry Blumberg is with Emory University School of Medicine, Department of Medicine, Atlanta. Ashutosh Tamhane is with University of Alabama at Birmingham, Department of Medicine. Anna Sevilla is with Global TB Institute, Rutgers Biological and Health Sciences. Randall Reves is with Denver Health and Hospitals Authority, Denver, CO.
authors.forename: Anna
authors.initials: A
authors.lastname: Sevilla
authors.affiliation: Amy L. Davidow is with Rutgers Biological and Health Sciences, New Jersey Medical School, Department of Preventive Medicine and Community Health, Newark. Dolly Katz and Smita Ghosh are with Centers for Disease Control and Prevention, Division of TB Elimination, Atlanta, GA. Henry Blumberg is with Emory University School of Medicine, Department of Medicine, Atlanta. Ashutosh Tamhane is with University of Alabama at Birmingham, Department of Medicine. Anna Sevilla is with Global TB Institute, Rutgers Biological and Health Sciences. Randall Reves is with Denver Health and Hospitals Authority, Denver, CO.
authors.forename: Randall
authors.initials: R
authors.lastname: Reves
mesh_terms: D000328:Adult; D017677:Age Distribution; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control*