Tuberculosis screening, diagnosis, and treatment of new U.S. immigrants

Immigrants represent a number of those not screened or treated for tuberculosis (TB) in the U.S. Missed opportunities for TB screening and treatment lead to greater public health risks for immigrant and native populations alike. Data from the most recent New Immigrant Survey were analyzed. Randomized sample included new, legal adult immigrants admitted to the U.S. (N=8,572). Chi-square analyses and Cramer's V were used to determine significance and magnitude of associations, respectively. Outcomes (TB test, positive TB test results, beginning TB treatment, and treatment completion) were measured across five demographic variables. Seventy percent of subjects had been tested for TB. Of those, 7.6% tested positive for TB. Treatment was started by 54.3% of TB-positive participants. Treatment completion was reported by 88.4% of participants. Men were less likely to be tested for TB (p<.05), and to report positive TB results (p<.0001). Immigrants who lived in a rural area at age 10 were less likely to have been screened (p<.05). Subjects not intending to live in the U.S. for the rest of their lives were less likely to complete treatment (p<.01, Cramer's V=.27). No association was found between living with others and any examined outcome measures (p>.05). Demographic associations of TB screening and treatment completion behaviors described should be considered when creating or revising TB prevention and treatment initiatives for immigrant populations.