The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68147

David C. Perlman, MD¹, Patricia Friedmann, MS², Leslie Horn, MPH¹, Ann Nugent, MS¹, Jeanne Carey, MD¹, and Don C. Des Jarlais, PhD³. (1) Department of Medicine; Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003, 212-420-4470, dperlman@bethisraelny.org, (2) Baron Edmond de Rothschild Chemical Dependency Insitiute, Beth Israel Medical Center, 215 Park Avenue, 15th Floor, New York City, NY 10003, (3) Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, 1st Avenue and 16th Street, New York, NY 10003

Objective: To examine trends in the prevalence of latent tuberculosis infection (LTBI) among active DUs at a SEP in NYC. Methods: DUs using a SEP in NYC were offered TB skin testing. Induration of >= 10 mm (or >= 5 mm with HIV-infection) was considered positive. Participants underwent a staff administered questionnaire. Results: 2,846 DUs were evaluated from 1995-2000. Mean age: 36 years (y); 30% female; 33% Black, 33% White, 34% Hispanic; 4% foreign born. Overall prevalence of LTBI was 13%. LTBI was associated with increased age (p<0.0001), foreign birth (p<0.0001) and Black race (p<0.0001). Prevalence did not change over time (p=0.3) nor were there significant changes by gender, foreign birth or any consistent change in race/ethnicity. Mean age increased over time (p<0.0001). LTBI prevalence did not change significantly during the study period among males, females, Blacks, Whites, Hispanics, or the foreign born. Among older DUs (age > 35 years) LTBI prevalence was 16% and did not change over time, while overall LTBI prevalence among younger DUs (age <= 35y) was 9% and declined over the study period (p=0.02). LTBI prevalence among older Black, White, or Hispanic DUs, and among younger White and Hispanic DUs did not change over time, while among younger Black DUs LTBI prevalence declined (p=0.046). Conclusions: Overall LTBI prevalence remains stable in this population which suggests a continued need for TB screening among active DUs. Stable prevalence among older DUs likely reflects exposures prior to the study period. Declining prevalence among younger DUs, especially younger black DUs, maybe due to reductions in rates of active TB and decreased risk of new LTBI.

Learning Objectives:

At the conclusion of the session, the participant will be able to:
• Describe the prevalence of latent TB infection (LTBI) among active drug users at a NYC syringe exchange program.
• Identify factors associated with the higher rates of LTBI among drug users.
• Recognize trends and changes over time in the prevalence of LTBI among drug users.

Keywords: TB, Drug Injectors

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.