title: Latent Tuberculosis Infection Among Immigrant and Refugee Children Arriving in the United States: 2010.
abstract: Immigrants and refugees age 2-14 years entering the United States from countries with estimated tuberculosis (TB) incidence rate ≥20 per 100,000 population are screened for TB. Children with TB disease are treated before US arrival. Children with positive tuberculin skin tests (TST), but negative TB evaluation during their pre-immigration examination, are classified with latent TB infection (LTBI) and are recommended for re-evaluation post-arrival. We examined post-immigration TB evaluation and therapy for children arriving with LTBI. We reviewed medical exam data from immigrant children with medical conditions and all refugee children arriving during 2010. Medical examination data were available for 67,334 children. Of these, 8231 (12 %) had LTBI pre-immigration; 5749 (70 %) were re-evaluated for TB post-immigration, and 64 % were retested by TST or IGRA. The pre-immigration LTBI diagnosis was changed for 38 % when retested by TST and for 71 % retested by IGRA. Estimated LTBI therapy initiation and completion rates were 68 and 12 %. In this population, testing with IGRA may limit the number of children targeted for therapy. Increased pre-immigration TB screening with post-immigration follow-up evaluation leading to completion of LTBI therapy should be encouraged to prevent TB reactivation.
authors.affiliation: Division of Global Migration and Quarantine, National Center of Emerging Zoonotic and Infectious Diseases, United States Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop E-04, Atlanta, GA, 30333, USA. ETaylor1@cdc.gov.|United States Public Health Service Commissioned Corps, Washington, DC, USA. ETaylor1@cdc.gov.
authors.forename: Eboni M
authors.initials: EM
authors.lastname: Taylor
authors.affiliation: Division of Global Migration and Quarantine, National Center of Emerging Zoonotic and Infectious Diseases, United States Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop E-04, Atlanta, GA, 30333, USA.|United States Public Health Service Commissioned Corps, Washington, DC, USA.
authors.forename: John
authors.initials: J
authors.lastname: Painter
authors.affiliation: Division of Global Migration and Quarantine, National Center of Emerging Zoonotic and Infectious Diseases, United States Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop E-04, Atlanta, GA, 30333, USA.|United States Public Health Service Commissioned Corps, Washington, DC, USA.
authors.forename: Drew L
authors.initials: DL
authors.lastname: Posey
authors.affiliation: Division of Global Migration and Quarantine, National Center of Emerging Zoonotic and Infectious Diseases, United States Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop E-04, Atlanta, GA, 30333, USA.|United States Public Health Service Commissioned Corps, Washington, DC, USA.
authors.forename: Weigong
authors.initials: W
authors.lastname: Zhou
authors.affiliation: Division of Global Migration and Quarantine, National Center of Emerging Zoonotic and Infectious Diseases, United States Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop E-04, Atlanta, GA, 30333, USA.|United States Public Health Service Commissioned Corps, Washington, DC, USA.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Shetty
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D015994:Incidence; D059425:Interferon-gamma Release Tests; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000208:ethnology*; D008297:Male; D012036:Refugees; D014374:Tuberculin Test; D014481:United States / Q000453:epidemiology
keywords: Interferon gamma release assay; Migrants; Pediatric; Tuberculin skin test