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APHA Scientific Session and Event Listing

Sharmila C. Subaran, BS¹, Marcia C. Trapé-Cardoso, MD¹, Anne L. Bracker, MPH¹, Edward Sapiain, Labor Educator², and Bruce E. Gould, MD³. (1) Department of Medicine, Division of Occupational & Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030-1905, 860-679-4564, ssubaran@student.uchc.edu, (2) ConnectiCOSH, 683 North Mountain Road, Newington, CT 06111, (3) Associate Dean of Primary Care, UConn School of Medicine, 263 Farmington Ave, Farmington, CT 06030-2926

Background: The prevalence of Latent Tuberculosis Infection (LTBI) among Connecticut (CT) migrant farmworkers is unknown. Estimates of LTBI prevalence among farmworkers in the US range from 31% - 76%. The estimated LTBI prevalence in the US population is 3.6-4.9%. TB persists as a global problem. This study estimates the prevalence of LTBI in high-risk CT farmworkers and describes the living conditions, which could increase the chance for transmission of active TB. Methods: Workers at one farm completed a questionnaire modeled after the Migrant Clinicians Network TB survey tool. A standardized Tuberculin Skin Test(TST)was performed; those with negative results were offered a second-step. Workers with positive results were referred for evaluation and treatment. An industrial hygienist completed a walkthrough the barracks. Data were analyzed with SPSS. Results: 57 Hispanic workers participated in the study. 26% were TST positive. None had symptoms or signs of active disease. When compared with published data on LTBI in US and foreign-born Hispanic farmworkers, our study showed a significantly lower number of positive TST results (P<0.001). When compared with the US population our study showed a significantly higher number of positive TST results (P<0.001). BCG vaccination history and residence in barracks for more than 1 year were not significant confounders. Conclusion: This pilot study suggests a high prevalence of LTBI among asymptomatic migrant farmworkers living in barracks in CT when compared with estimates for the US population. The true prevalence of LTBI among migrant workers will require more studies.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Recognize the magnitude of Tuberculosis infection as a global problem especially affecting migrant farmworkers from high prevalence countries and with minimal access to health care resources in the US.
• Identify barriers to obtain data on surveillance for latent TB infection among migrant workers.
• Identify issues for TB control among workers residing in barracks including the environmental conditions in dormitories.
• Describe strategies for an effective surveillance program among migrant farmworkers residing in barracks.

Keywords: TB, Migrant Farm Workers

Presenting author's disclosure statement:

Any relevant financial relationships? No