Overseas Screening for Tuberculosis in U.S.-Bound Immigrants and Refugees

Abstract

Overseas screening for tuberculosis with follow-up evaluation after arrival in the United States is a high-yield intervention for identifying tuberculosis in U.S.-bound immigrants and refugees and could reduce the number of tuberculosis cases among foreign-born persons in the United States.

Active screening at entry for tuberculosis among new immigrants: a systematic review and meta-analysis

“…Our findings are consistent with the estimates reported from the overseas screening of US-bound immigrants and refugees. The reported analyses show that prevalence (per 1,000 screened) among refugees is larger (10.4, 95% CI 10.0-10.7) than among other immigrants (9.6, 95% CI 9.5-9.7) [10]. Unfortunately, those values are not readily comparable with our estimates since they refer exclusively to smear-negative tuberculosis cases, whereas our analysis accounts also for smear-positive cases.…”

“…The issues of surveillance of communicable diseases and screening of migrants for tuberculosis are politically sensitive topics that need robust evidence about the burden of immigrant-associated tuberculosis and about the efficacy of screening services to be adequately addressed [7][8][9]. Very recently, overseas screening has been reported as a high-yield intervention for indentifying tuberculosis in regular immigrants and refugees in their countries of origin [10]. Similarly, contact tracing among migrants and the foreign-born population has been recently reviewed as a potentially effective, though poorly standardised, strategy to identify cases in a highprevalence population [11].…”

Domestic impact of tuberculosis screening among new immigrants to Ontario, Canada

“…20 A recent large-scale study of US-bound immigrants and refugees identified high rates of smear-negative pulmonary TB (i.e., 3 negative smears with chest radiographic markers suggestive of active TB) on overseas screening, with most cases identified in immigrants from a short list of high-incidence countries. 21 Our analysis complements those findings, in that our primary outcome is active TB confirmed through culture, our study period includes up to 10 years' postimmigration followup and we identify person-level risk factors for the future development and timing of active TB. Furthermore, our study differentiates TB risks between overseas and domestic applicants for permanent residency, describes outcomes of TB screening by country of birth and quantifies the potential and actual impact of postimmigration surveillance on the domestic burden of active TB in patients born abroad.…”

The impact of tuberculosis and chemotherapy on female reproductive health

“…Туберкулез у ЖРВ чаще всего выявляется при обращении за медицинской помощью (69,6%), профилак-тическом осмотре (30,4%); в первый месяц после родов (17,5%); в течение 1 года после родов (36,7%); через 1-2 года после родов (45,8%). При этом преобладают деструк-тивные формы (53,2%) с бактериовыделением (59,6%), наличием множественной лекарственной устойчивости -МЛУ (14,2%) [5].Высокая заболеваемость туберкулезом среди ЖРВ и ежегодный рост числа случаев туберкулеза у женщин во время беременности и послеродовом периоде определяют чрезвычайную актуальность своевременной диагностики …”

“…Туберкулез у ЖРВ чаще всего выявляется при обращении за медицинской помощью (69,6%), профилак-тическом осмотре (30,4%); в первый месяц после родов (17,5%); в течение 1 года после родов (36,7%); через 1-2 года после родов (45,8%). При этом преобладают деструк-тивные формы (53,2%) с бактериовыделением (59,6%), наличием множественной лекарственной устойчивости -МЛУ (14,2%) [5].…”