title: Use of Transnational Services to Prevent Treatment Interruption in Tuberculosis-Infected Persons Who Leave the United States.
abstract: A major problem resulting from interrupted tuberculosis (TB) treatment is the development of drug-resistant TB, including multidrug-resistant TB (MDR TB), a more deadly and costly-to-treat form of the disease. Global health systems are not equipped to diagnose and treat the current burden of MDR TB. TB-infected foreign visitors and temporary US residents who leave the country during treatment can experience treatment interruption and, thus, are at greater risk for drug-resistant TB. Using epidemiologic and demographic data, we estimated TB incidence among this group, as well as the proportion of patients referred to transnational care-continuity and management services during relocation; each year, ≈2,827 visitors and temporary residents are at risk for TB treatment interruption, 222 (8%) of whom are referred for transnational services. Scale up of transnational services for persons at high risk for treatment interruption is possible and encouraged because of potential health gains and reductions in healthcare costs for the United States and receiving countries.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Tschampl
authors.forename: Deborah W
authors.initials: DW
authors.lastname: Garnick
authors.forename: Edward
authors.initials: E
authors.lastname: Zuroweste
authors.forename: Moaven
authors.initials: M
authors.lastname: Razavi
authors.forename: Donald S
authors.initials: DS
authors.lastname: Shepard
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D003266:Continuity of Patient Care; D019468:Disease Management; D004641:Emigration and Immigration; D006801:Humans; D015994:Incidence; D007391:International Cooperation; D014195:Travel; D014376:Tuberculosis / Q000453:epidemiology / Q000628:therapy*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000628:therapy
chemical_list: D000995:Antitubercular Agents
keywords: TB; United States; antimicrobial resistance; continuity of patient care; cross-border cases; drug resistance; emigration; immigration; incidence; interventions; multidrug resistance; multidrug-resistant tuberculosis; treatment interruption; tuberculosis; tuberculosis and other mycobacteria