International collaborations to prevent transmission of diseases and improve immigrant and refugee health

Each year, approximately 400,000 immigrants and 50,000 refugees enter the United States. Because of the diverse health needs of these two groups and the ease of disease translocation, an overseas medical screening examination is required prior to immigration. The Division of Global Migration and Quarantine (DGMQ), Centers for Disease Control and Prevention (CDC), has the regulatory authority to oversee the quality of the required medical examination to screen for tuberculosis, human immunodeficiency virus, syphilis and certain other sexually transmitted diseases, Hansen's disease, mental disorders, and substance abuse. To meet this responsibility, DGMQ provides technical guidance to overseas physicians who perform the examination in 670 sites. DGMQ designates multidisciplinary teams with medical and laboratory expertise that perform on-site visits using standardized evaluation tools. Since 1999, the DGMQ teams have visited 187 sites in 43 countries, and in addition to providing guidance to overseas physicians, help in remediating any deficiencies identified during these visits. This multidisciplinary approach and collaboration with international health-care providers, ministries of health, and migrant-receiving countries that perform overseas health assessments help identify facilities that provide quality health services, optimize the medical examination processes, and increase clinical and laboratory capacity in originating countries. Working with other migrant-receiving countries, DGMQ promotes partnerships that should facilitate the harmonization of policies and integration of global migration health issues. We will present the details of this important strategy to address common immigration health problems, such as tuberculosis, and prevent the importation and transmission of diseases.