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A Centers for Disease Control and Prevention (CDC) study published today shows that because of new screening guidelines issued in 2007, physicians overseas identified 629 additional cases of tuberculosis (TB) in 2012 among immigrants and refugees bound for the United States. Without these updated screening guidelines, which use newer, more sensitive tests, these cases might have gone undetected. When these screening guidelines are implemented in all countries, physicians overseas could continue to identify more than 600 additional cases of tuberculosis each year. This makes this effort one of the largest and most successful interventions for U.S. TB control in the past decade.
The article, “Effect of a Culture-Based Screening Algorithm on Tuberculosis Incidence in Immigrants and Refugees Bound for the United States,” was published today in the Annals of Internal Medicine and is available at http://www.annals.org/article.aspx?doi=10.7326/M14-2082. An accompanying video is available at http://annals.org/multimediaPlayer.aspx?mediaid=9577243.
Since the early 1900s, immigrants and refugees applying for a visa to come to the United States undergo a medical examination that includes TB screening. In 2007, CDC began implementing the screening guidelines, which require people suspected of having TB to receive a much more sensitive sputum culture test to confirm TB to ensure that people who do have TB receive treatment before they arrive in the United States. These requirements have now been completely implemented in all countries with U.S.-bound immigrants and refugees.
From 2007 through 2012, half of the 3.2 million arrivals of immigrants and refugees to the United States were screened for TB using the 2007 screening guidelines. Out of more than 4,000 TB cases diagnosed using the screening guidelines during this period; nearly 2,200 were smear-negative and culture-positive. These cases would likely have been missed under the previous screening requirements. The results of this study showed that the updated overseas screening guidelines led to a roughly one-third decrease in the number of TB cases among foreign-born persons within their first year in the United States.
For more information on immigration and testing overseas, visit: http://www.cdc.gov/immigrantrefugeehealth/index.html