Test More Foreign-Born U.S. Residents for TB: Experts

Better screening, treatment could help eliminate domestic cases

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THURSDAY, Jan. 4, 2007 (HealthDay News) -- Tuberculosis will only be eradicated in the United States if all foreign-born residents from high-risk countries are tested and, if necessary, treated for latent TB infection, a new report finds.

The current guidelines recommend targeting people who have lived in the United States for five years or less for tuberculin skin testing and treatment of latent TB infection.

"Twenty-five percent of all reported TB cases in the United States are among foreign-born persons who have lived in the U.S. for more than five years," Kevin Cain, of the Division of Tuberculosis Elimination at the U.S. Centers for Disease Control and Prevention in Atlanta, said in a prepared statement. "There is no policy to test foreign-born persons for the latent TB infection before entering the U.S., or to test them after they have lived here for more than five years. As such, present guidelines do not currently address the burden of latent TB infection in the foreign-born subgroup."

For the report, which is published in the Jan. 1 issue of the American Journal of Respiratory and Critical Care Medicine, Cain and his colleagues investigated why the number of TB cases in U.S.-born residents declined by 62 percent from 1993 to 2004, while the number of foreign-born cases increased by 5 percent.

"For example, in 2004, a total of 14,517 cases of TB were reported," Cain said in the statement. "Of these, 3,444, or 24 percent, were foreign-born persons who had entered the United States more than five years previously."

The researchers collected data on all 2004 TB cases listed in the U.S. National TB Surveillance database.

They found that the following countries of origin of U.S. immigrant residents had the largest number of TB cases in 2004: Mexico, Philippines, Vietnam, India, China, Haiti, South Korea, and Guatemala, Ethiopia and Peru.

To eliminate the disease, according to the report, the current guidelines should be changed to reclassify all foreign-born residents from high-incidence countries as "high-risk," regardless of the amount of time they have lived in the United States.

"Until we address the burden of latent TB infection in the foreign-born group, achieving TB elimination will not be possible," Cain said.

More information

The National Institute of Allergy and Infectious Diseases has more about tuberculosis.

SOURCE: American Thoracic Society, news release, Jan. 2, 2007

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