Foreign-born students in US have higher case rate of TB
Jeffrey M. Collins, M.D., M.P.H., from the Emory University School of Medicine in Atlanta, and colleagues characterized the risk of TB in international students entering the United States using data collected by 18 TB control jurisdictions. The analysis included a cohort of 1,268 foreign-born patients of known visa status diagnosed with active TB between 2004 and 2007.
The researchers diagnosed 46 TB cases in student residents, providing an annual estimate of 308 cases nationally. In student residents, the estimated TB case rate was more than double that of the general foreign-born population, at 48.1 cases per 100,000 person-years. The likelihood of being diagnosed within six months of U.S. arrival was higher for students who were identified by TB screening programs (75 versus 6 percent; P < 0.001). Compared with those not screened, students identified by screening program with pulmonary disease were less likely to have a positive sputum smear for acid-fast bacilli (18 versus 63 percent; P = 0.05). Seventy-one percent of unscreened students were diagnosed over one year after U.S. arrival; 6 percent had undergone prior treatment for latent TB infection.
"Screening this group after arrival to the U.S. is an effective strategy for earlier diagnosis of active TB," the authors write.
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