Tuberculosis among Foreign-born Persons in the United States

Abstract

Almost one-quarter of all TB cases in the United States occur among foreign-born persons who have resided in the United States for longer than 5 yr; case rates for such persons from selected regions of origin remain substantially elevated. To eliminate TB, we must address the burden of LTBI in this high-risk group.

Immigrants and tuberculosis in Hong Kong

“…18 The higher SIR and drug resistance prevalence among Mainland immigrants and immigrants from Groups III-V Asia countries corroborate reports of higher TB incidence [2][3][4][5][6]8 and drug resistance 7,12 among immigrants in low-TB-burden countries. These higher risks among immigrants may have resulted at least in part from reactivation of latent TB infection 9-11 acquired during their previous residence in, and/or travel to, their places of birth with higher burdens of TB and/ or drug resistance.…”

“…1 Immigrants from these high-burden areas have often been blamed for their impact on the TB situation in many developed areas. [2][3][4][5][6][7][8][9][10][11][12] A rapid increase in population was observed in Hong Kong in the last century, largely due to a heavy influx of immigrants New knowledge added by this study • Immigrants carry with them a higher tuberculosis incidence and/or drug resistance rate from their place of origin to Hong Kong. Implications for clinical practice or policy • Their higher drug resistance rate, poorer treatment outcome, and excess relapse risk may increase the risk of secondary transmission of drug-resistant tuberculosis within the local community.…”

The Pandemic Nature of Reemerging Tuberculosis and the Role of Population Migration in its Spread

“…In one study in the United States, among the foreign-born population overall, TB case rates declined with increasing time since US entry, but remained higher than among US-born persons-even more than 20 years after arrival. In total, 53% of TB cases among foreign-born persons occurred among the 22% of the foreign-born population born in sub-Saharan Africa and Southeast Asia [33]. Recent studies suggest a re-emergence of tuberculosis among foreign-born children in the State of Florida as from 1997 after several years of decline.…”

Primary care pearls to help eliminate tuberculosis in Canada

“…In addition, this study demonstrated that the category of immigrants was associated with an increased risk of developing active TB disease following their arrival in Canada, with live-in caregivers and refugees at the highest risk (7). The risk of active TB disease reactivation is highest in the first two years following arrival and decreases with every subsequent year (17). In addition, in the medical history it is important to elicit the region of residence and ethnicity of Canadian-born individuals since some regions and populations within Canada, including Canadian-born Indigenous peoples, have higher TB incidence.…”