The Epidemiology of Tuberculosis among Foreign-Born Persons in the United States, 1986 to 1993

McKenna, Matthew T.; McCray, Eugene; Onorato, Ida M.

doi:10.1056/nejm199504203321606

Cited by 312 publications

(137 citation statements)

References 34 publications

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“…4 The increasing influx of foreign-born individuals from TB endemic regions and the coepidemic of HIV infection with its risk for a higher rate of TB reactivation in the previously infected adult population have contributed to this resurgence. [1][2][3] At first glance, our data would seem to mirror that described in the CDC report, with an increase in pediatric TB cases beginning in 1989, continuing without a definite decline until 1995, and decreasing more significantly in the last 2 years. Additionally, foreign-born children contributed significantly in our series to the prevalence of TB in this area and our rate of 29.3% was similar to that of 19% to 23% reported by the CDC for the overall national experience.…”

Section: Discussionsupporting

confidence: 47%

“…This increase, which persisted through the early-to mid-1990s, was fueled by the human immunodeficiency virus (HIV) epidemic and by an increasing proportion of active disease in foreign-born individuals. 1,2 Although most of the attention was directed toward the significant rise of disease in adults, there was an alarming increase in the pediatric-aged population as well. 3,4 Much of the pediatric disease was identified in minority populations, especially in children from large cities, mirroring the increasing epidemic in adults.…”

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confidence: 99%

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Mycobacterium bovis as a Significant Cause of Tuberculosis in Children Residing Along the United States–Mexico Border in the Baja California Region

Dankner

Davis

2000

Pediatrics

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ABSTRACT. Objective. To determine the role of Mycobacterium bovis in active pediatric tuberculosis (TB) in a United States-Mexico border region.Method. We reviewed all new cases of pediatric (<15 years old) TB presenting to San Diego hospitals and clinics from 1980 to 1997. Patients were categorized by age, ethnicity, country of origin, culture results, and disease manifestations. Case definitions were similar to those used by the Centers for Disease Control and Prevention. M bovis was distinguished from Mycobacterium tuberculosis by standard biochemical tests.Results. The median age of the 563 identified patients was 4.1 years old. The yearly incidence began rising in 1989 and peaked in the mid-1990s. Hispanics constituted 78.9% of the patients, but they were less likely to be foreign-born (21.6%) than were black children and Asian/ Pacific Islanders. Overall, M bovis caused 10.8% of all TB during this period. Of the 180 patients with positive culture results, however, M bovis accounted for 33.9% and M tuberculosis 66.1%. This high percentage of M bovis infections was largely attributable to its contribution to extrapulmonary TB (55.2% of all culture-positive specimens). M bovis patients were also even more likely to be Hispanic (90.2%), to present with extrapulmonary disease (95.1%), and to be older than 12 months (96.8%).Conclusion. These data demonstrate the dramatic impact of this underappreciated cause of zoonotic TB on US children at the Mexican border and underscore the need for cross-collaboration to enforce existing Mexican pasteurization laws. Pediatrics 2000;105(6). URL: http:// www.pediatrics.org/cgi/content/full/105/6/e79; pediatric tuberculosis, Mycobacterium bovis, Mycobacterium tuberculosis, zoonotic tuberculosis, extrapulmonary tuberculosis, United States-Mexico border area.ABBREVIATIONS. HIV, human immunodeficiency virus; TB, tuberculosis; CDC, Centers for Disease Control and Prevention; PPD, purified protein derivative; INH, isoniazid; AFB, acid-fast bacillus.B eginning in the mid-1980s, a sharp increase in the incidence and prevalence of tuberculous disease in the United States reversed the steady decline of the last several decades. This increase, which persisted through the early-to mid-1990s, was fueled by the human immunodeficiency virus (HIV) epidemic and by an increasing proportion of active disease in foreign-born individuals.1,2 Although most of the attention was directed toward the significant rise of disease in adults, there was an alarming increase in the pediatric-aged population as well. 3,4 Much of the pediatric disease was identified in minority populations, especially in children from large cities, mirroring the increasing epidemic in adults. 3Traditional teaching has stressed that children with tuberculous disease are sentinel events for active adult disease and that preadolescents usually acquire disease from close contact with a family member or other adult household contact.4 Because aerosols are the route of transmission to these pediatric patients, Mycobacterium tubercu...

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Section: Discussionsupporting

confidence: 47%

mentioning

confidence: 99%

Mycobacterium bovis as a Significant Cause of Tuberculosis in Children Residing Along the United States–Mexico Border in the Baja California Region

Dankner

Davis

2000

Pediatrics

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“…2 TB programs are now making efforts to do TSTs in clinics and other medical facilities serving groups at high risk of acquiring TB infection or disease including persons with HIV infection, drug users, prisoners, and the foreign-born. 1 -3 Focused screening programs that can reach the foreign-born are especially important because percentages of US TB cases attributed to foreign-born persons have increased for more than a decade, 14 and the numbers of US immigrants from countries with high TB prevalence also have increased during the same time. 15 If TB programs are to expect cooperation with TST screening from facilities like the prenatal clinics at JMH, effective TB training must be developed to permit obstetricians and gynecologists to effectively test for TB and to treat LTBI.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis Skin Testing Among HIV-Infected Pregnant Women in Miami, 1995 to 1996

et al. 2002

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“…2 Furthermore, despite decreases in the total number of cases in the United States, the proportion of cases among people born abroad is increasing, with a 1998 rate of infection four to six times higher than among people born in the United States. [3][4][5][6] As TB, a treatable and curable disease, continues to be a health problem in the United States, strategies to increase adherence to TB treatment need to be identified and implemented. Adherence to anti-TB medication is of particular concern in geographic areas and populations with high TB prevalence rates.…”

mentioning

confidence: 99%

Behavioral Interventions for the Control of Tuberculosis Among Adolescents

Morisky

Malotte²,

Ebin³

et al. 2001

Public Health Reports

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SYNOPSISObjectives. Activation of latent tuberculosis infection into tuberculosis disease (TB), the primary killer among infectious diseases worldwide, can be prevented with six months of anti-TB medication. A large percentage of adolescents started on medication, however, fail to complete their treatment. The authors developed and tested the effects of innovative educational strategies on infected adolescents at two health centers serving ethnically diverse populations.Methods. The authors used a randomized experimental four-group design to assess the independent and combined effects of peer counseling and a participant-parent contingency contract intervention.Results. A total of 794 adolescents were recruited into the study, for a 79% participation rate. The overall rate of treatment completion was 79.8%. Selfefficacy for medication-taking behavior at post-test correlated strongly with completion of care (R = 0.367, p = 0.002). Participants randomized to the peer counseling groups demonstrated significantly greater improvements in selfefficacy and mastery than the usual care control group. Based on the study results, continuing education seminars and workshops were implemented for TB control staff at the two health clinics and for all TB Control Division staff at the Los Angeles County Health Department. Educational materials and a training manual for enhancing completion of treatment of latent TB infection through tailored educational approaches were developed and disseminated to the clinics.Conclusions. Health education and incentives are helpful adjuncts to the completion of treatment for latent tuberculosis infection in adolescents.

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The Epidemiology of Tuberculosis among Foreign-Born Persons in the United States, 1986 to 1993

Cited by 312 publications

References 34 publications

Mycobacterium bovis as a Significant Cause of Tuberculosis in Children Residing Along the United States–Mexico Border in the Baja California Region

Mycobacterium bovis as a Significant Cause of Tuberculosis in Children Residing Along the United States–Mexico Border in the Baja California Region

Tuberculosis Skin Testing Among HIV-Infected Pregnant Women in Miami, 1995 to 1996

Behavioral Interventions for the Control of Tuberculosis Among Adolescents

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