23.7.2008

Bloomberg (7/23, Bennett) reports that "[i]mmigrants to the U.S. from Africa and Southeast Asia should be tested and treated for tuberculosis (TB) before they arrive to prevent importing the disease," according to a study published in the July 23/30 issue of the Journal of the American Medical Association. Kevin P. Cain, M.D., of the Centers for Disease Control and Prevention (CDC), and colleagues, pointed out that "screening immigrants and refugees from the Philippines and Vietnam would have detected almost half the average 250 TB cases brought into the U.S. each year from 2001 to 2006."

The AP (7/23, Tanner) adds that the "researchers called for wider testing, including efforts to seek out latent cases of TB from long-term immigrant residents in certain populations." (continued...)

( For the study, the investigators "reviewed 46,970 cases of TB among foreign-born individuals in the United States,"HealthDay (7/23, Gardner) noted. The authors "discovered that an immigrant's risk for TB was highest during the early years after first arriving in the United States, varied with age (older people had a higher risk), and also varied by country of birth." In fact, they "found that over 50 percent of all cases of TB among foreign-born persons occurred among 20 percent of the overall foreign-born populations, especially persons born...in Southeast Asia [particularly the Philippines and Vietnam] and sub-Saharan Africa."

In contrast to people born in these regions, whose TB risk was "greater than 250 per 100,000 persons during the first two years after U.S. entry," the "risk was low among those born in Western Europe, Canada, Australia, and New Zealand, all of which had rates of less than 10 per 100,000 persons," MedPage Today (7/22, Groch) reported. Notably, resistance to the first-line TB drug Isoniazid (isonicotinic acid hydrazide) "was as high as 20 percent among recent entrants from Vietnam, 18 percent among those from Peru, 17 percent among those from the Philippines, and 16 percent in those from China." The authors concluded that while "testing and treatment for latent TB cannot be fully implemented, its yield could be higher by focusing on the highest-risk groups of foreign-born persons first."