Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117825

Laura J. Hardcastle, BS and Carolyn Lynch, MS, RN. Refugee Health Section, California Department of Health Services, P.O. Box 997413, MS 5204, Sacramento, CA 95899-7413, (916) 552-8268, lhardcas@dhs.ca.gov

In 2004, approximately 8,800 Hmong refugees resettled to 27 states, with California receiving approximately 3,200. Refugees diagnosed with Class A tuberculosis (TB) were required to complete treatment prior to arrival in the United States and no Class A TB was reported among arriving Hmong refugees in the Division of Global Migration and Quarantine system. Stateside screening in California identified several cases of active TB and multi-drug resistant TB that led to enhanced overseas screening. The Centers of Disease Control and Prevention calculated expected rates of active and inactive TB among the newly arrived Hmong refugees between 21.3 - 90.4 per 100,000 persons and between 3.5 - 33.6 per 100,000 persons, respectively. High rates even compared with TB rates among foreign-born persons in the United States. Cases of multi-drug resistant TB have been found in long-term Hmong communities.

Hmong compliance to treatment for active TB and multi-drug resistant TB has been difficult. Due to the critical need to ensure compliance for treatment for active TB and MDR-TB, the California Refugee Health Program will discuss:

• The process employed to reframe the mainstream approach to improve outreach strategies and treatment compliance. • Innovative partnerships developed to collaboratively explore solutions for improving treatment compliance. • Reasons for non-compliance. • Measures taken to create an understanding between Western health care treatment practices and Hmong cultural beliefs. • Measures taken to obtain “buy-in” from Hmong community to support the program goal of treatment compliance for new and long-term Hmong refugees.

Learning Objectives:

• • Identify cultural interventions employed to mitigate backlash and stigma related to tuberculosis (TB) and the Hmong community.
• • Understand the factors that facilitate or inhibit the treatment of active TB and multi-drug resistant TB.

Keywords: Refugees, Tuberculosis

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.