Tuberculosis Screening Among Foreign-Born Persons Applying for Permanent US Residence

Saraiya, Mona; Cookson, Susan T.; Tribble, Paul; Silk, Benjamin J.; Cass, Robert; Poonja, Shameer; Walting, Marva; Howland, Noelle; Paz, E. Antonio; Cochran, Jennifer; Moser, Kathleen; Oxtoby, Margaret J.; Binkin, Nancy

doi:10.2105/ajph.92.5.826

Cited by 16 publications

(6 citation statements)

References 7 publications

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“…In addition, the completion rates for latent TB infection (LTBI) did not take into account the following: refusal to undergo tuberculin testing; failure of those with positive TST to report for medical evaluation; physician noncompliance with guidelines for the prescription of therapy; and refusal of patients to start the therapy. In several reports from large-scale screening programmes, these problems resulted in a very substantial reduction in overall programme effectiveness, as only 11-30% of individuals with a positive TST completed an adequate course of LTBI therapy [34,[70][71][72][73][74].…”

Section: Screening For Latent Tb Infectionmentioning

confidence: 99%

Cost-effectiveness of tuberculosis control strategies among immigrants and refugees

Dasgupta

Menzies

2005

European Respiratory Journal

135

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Today, in Western Europe, Canada and the USA, more than half of all new active tuberculosis (TB) cases occur among foreign-born migrants. This article examines the impact of migration from high TB-incidence to low TB-incidence countries, and compares the costeffectiveness of different TB control strategies.A Medline search was conducted to identify relevant English language publications prior to December 2003. Additional articles were identified from the reference lists from these publications.Despite the high proportion of active cases in low-incidence countries attributable to foreignborn residents, the public health impact is relatively low. Current chest radiograph screening programmes have little impact and are not cost-effective. Screening with sputum culture would improve cost-effectiveness marginally. Treatment of latent infection detected through screening with tuberculin skin testing or chest radiographs may require coercive measures to maximise impact and cost-effectiveness. In contrast, contact tracing, particularly within ethnic communities, appears to be more cost-efficient and less intrusive.In low-incidence countries, screening of migrants at entry has little overall impact and is not a very cost-effective tuberculosis control strategy. More effective alternatives include contact tracing delivered through primary care and increased investment in global tuberculosis control.

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Section: Screening For Latent Tb Infectionmentioning

confidence: 99%

Cost-effectiveness of tuberculosis control strategies among immigrants and refugees

Dasgupta

Menzies

2005

European Respiratory Journal

135

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“…An analysis of TB screening outcomes for status adjustment medical exams, as reported on USCIS forms, performed in 1997 and 1998 in San Diego, San Francisco, New York, and Massachusetts also found moderate adherence among CS to the CDC’s technical instructions: 74 % (4,121 of 5,570) of adjustors were appropriately screened [10]. Of those who were not evaluated appropriately, 1,172 (21 %, range 8–52 %) were referred for a CXR with no prior administration of a TST.…”

Section: Discussionmentioning

confidence: 99%

“…To perform status adjustment assessments, CS follow the Technical Instructions for Medical Examination of Aliens , requirements and recommendations published by the Centers for Disease Control and Prevention (CDC) in 1991 and revised in 2008 [9]; however, limited training has been provided. Furthermore, a 1997 assessment of CS adherence to the technical instructions revealed problems in screening practices [10]. …”

Section: Introductionmentioning

confidence: 99%

Civil Surgeon Tuberculosis Evaluations for Foreign-Born Persons Seeking Permanent U.S. Residence

Bemis

Thornton

Rodríguez-Lainz

et al. 2015

J Immigrant Minority Health

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Foreign-born persons in the United States seeking to adjust their status to permanent resident must undergo screening for tuberculosis (TB) disease. Screening is performed by civil surgeons (CS) following technical instructions by the Centers for Disease Control and Prevention. From 2011 to 2012, 1,369 practicing CS in California, Texas, and New England were surveyed to investigate adherence to the instructions. A descriptive analysis was conducted on 907 (66 %) respondents. Of 907 respondents, 739 (83 %) had read the instructions and 565 (63 %) understood that a chest radiograph is required for status adjustors with TB symptoms; however, only 326 (36 %) knew that a chest radiograph is required for immunosuppressed status adjustors. When suspecting TB disease, 105 (12 %) would neither report nor refer status adjustors to the health department; 91 (10 %) would neither start treatment nor refer for TB infection. Most CS followed aspects of the technical instructions; however, educational opportunities are warranted to ensure positive patient outcomes.

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“…Most industrialised countries use a combination of CXR and TST to screen immigrants originating from high-TB-incidence countries [12][13][14][15]. The Israeli TB screening policy in Addis Ababa, Ethiopia includes both of these methods for the detection of LTBI and PTB.…”

Section: From the Authorsmentioning

confidence: 99%

Pre-immigration screening for pulmonary tuberculosis

Mor¹,

Lerman²,

Leventhal³

2009

European Respiratory Journal

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Tuberculosis Screening Among Foreign-Born Persons Applying for Permanent US Residence

Abstract: Focused physician education and periodic monitoring of adherence to screening guidelines are warranted.

Cited by 16 publications

References 7 publications

Cost-effectiveness of tuberculosis control strategies among immigrants and refugees

Cost-effectiveness of tuberculosis control strategies among immigrants and refugees

Civil Surgeon Tuberculosis Evaluations for Foreign-Born Persons Seeking Permanent U.S. Residence

Pre-immigration screening for pulmonary tuberculosis

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