Objectives. We sought to characterize postimmigration tuberculosis (TB) care for Class B immigran... more Objectives. We sought to characterize postimmigration tuberculosis (TB) care for Class B immigrants and refugees at the Baltimore City Health Department TB program (BCHD), and to determine the proportion of immigrants with active TB or latent TB infection (LTBI) in this high-risk population. Methods. We conducted a retrospective chart review of Class B immigrants and refugees who reported to the BCHD for postimmigration TB evaluation from 2010 to 2012. Results. We reviewed the clinical records of 153 Class B immigrants; 4% were diagnosed with active TB and 53% were diagnosed with LTBI. Fifty percent of active TB cases were culture positive, and 67% were asymptomatic; 100% received and completed active TB therapy at the BCHD. Among those diagnosed with LTBI, 87% initiated LTBI therapy and 91% completed treatment. Conclusions. The high prevalence of active TB and LTBI found among Class B immigrants underscore the importance for postarrival TB screening. The absence of reported symptom...
We sought to determine the proportion of refugee patients at the Baltimore City Health Department... more We sought to determine the proportion of refugee patients at the Baltimore City Health Department Tuberculosis program (BCHD-TB) successfully completing latent tuberculosis infection (LTBI) treatment, as compared to other referral groups, and to identify factors associated with treatment completion. We completed a retrospective cohort analysis of individuals referred to BCHD-TB program for LTBI care between February 1, 2009 and March 31, 2011. Among 841 patients evaluated by BCHD-TB and diagnosed with LTBI, 81% of refugees, 50% of non-refugee foreign-born, and 35% of US-born patients completed LTBI treatment. In multivariate analysis, refugees had greater odds of LTBI treatment completion (Adjusted Odds Ratio 7.2; 95% CI 4.2-12.4, p < 0.001) compared to US-born individuals adjusting for age, gender, and treatment regimen. Overall, LTBI treatment completion remains suboptimal. At BCHD-TB, LTBI treatment completion was significantly higher among refugees than other referral groups. Additional efforts are needed to optimize LTBI care, and future efforts may need to be tailored for different risk groups.
Infection Control & Hospital Epidemiology, 2014
Background.Controlling tuberculosis (TB) infection among occupationally exposed healthcare worker... more Background.Controlling tuberculosis (TB) infection among occupationally exposed healthcare workers (HCWs) may be challenging.Methods.We retrospectively reviewed clinical records of HCWs who were exposed to patients diagnosed with infectious TB at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2008 and 2010. The collected data included baseline tuberculin skin test (TST) status, potential predictors of TST positivity, postexposure diagnosis of latent TB infection (LTBI), and postexposure compliance with LTBI therapy.Results.Thirteen patients were diagnosed with infectious pulmonary TB during the study period. A total of 298 HCWs met our definition for exposure. Exposed HCWs tended to be female (62.9%), non-Saudi (83.9%), nurses (68.6%), or respiratory therapists (24.0%) working in critical care locations (72.8%). Baseline (preemployment) TST documentation existed for 41.3% (123/298). Among those with documented baseline TSTs, 51.2% (63/123) were positive, representing 21....
… and Bioterrorism: Biodefense Strategy, Practice, and …, 2006
In addition to providing potable drinking water, US water systems are critical to the maintenance... more In addition to providing potable drinking water, US water systems are critical to the maintenance of many vital public services, such as fire suppression and power generation. Disruption of these sys-tems would produce severe public health and safety risks, as well as considerable ...
… and Bioterrorism: Biodefense Strategy, Practice, and …, 2006
In addition to providing potable drinking water, US water systems are critical to the maintenance... more In addition to providing potable drinking water, US water systems are critical to the maintenance of many vital public services, such as fire suppression and power generation. Disruption of these sys-tems would produce severe public health and safety risks, as well as considerable ...
Objectives. We sought to characterize postimmigration tuberculosis (TB) care for Class B immigran... more Objectives. We sought to characterize postimmigration tuberculosis (TB) care for Class B immigrants and refugees at the Baltimore City Health Department TB program (BCHD), and to determine the proportion of immigrants with active TB or latent TB infection (LTBI) in this high-risk population. Methods. We conducted a retrospective chart review of Class B immigrants and refugees who reported to the BCHD for postimmigration TB evaluation from 2010 to 2012. Results. We reviewed the clinical records of 153 Class B immigrants; 4% were diagnosed with active TB and 53% were diagnosed with LTBI. Fifty percent of active TB cases were culture positive, and 67% were asymptomatic; 100% received and completed active TB therapy at the BCHD. Among those diagnosed with LTBI, 87% initiated LTBI therapy and 91% completed treatment. Conclusions. The high prevalence of active TB and LTBI found among Class B immigrants underscore the importance for postarrival TB screening. The absence of reported symptom...
We sought to determine the proportion of refugee patients at the Baltimore City Health Department... more We sought to determine the proportion of refugee patients at the Baltimore City Health Department Tuberculosis program (BCHD-TB) successfully completing latent tuberculosis infection (LTBI) treatment, as compared to other referral groups, and to identify factors associated with treatment completion. We completed a retrospective cohort analysis of individuals referred to BCHD-TB program for LTBI care between February 1, 2009 and March 31, 2011. Among 841 patients evaluated by BCHD-TB and diagnosed with LTBI, 81% of refugees, 50% of non-refugee foreign-born, and 35% of US-born patients completed LTBI treatment. In multivariate analysis, refugees had greater odds of LTBI treatment completion (Adjusted Odds Ratio 7.2; 95% CI 4.2-12.4, p < 0.001) compared to US-born individuals adjusting for age, gender, and treatment regimen. Overall, LTBI treatment completion remains suboptimal. At BCHD-TB, LTBI treatment completion was significantly higher among refugees than other referral groups. Additional efforts are needed to optimize LTBI care, and future efforts may need to be tailored for different risk groups.
Infection Control & Hospital Epidemiology, 2014
Background.Controlling tuberculosis (TB) infection among occupationally exposed healthcare worker... more Background.Controlling tuberculosis (TB) infection among occupationally exposed healthcare workers (HCWs) may be challenging.Methods.We retrospectively reviewed clinical records of HCWs who were exposed to patients diagnosed with infectious TB at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2008 and 2010. The collected data included baseline tuberculin skin test (TST) status, potential predictors of TST positivity, postexposure diagnosis of latent TB infection (LTBI), and postexposure compliance with LTBI therapy.Results.Thirteen patients were diagnosed with infectious pulmonary TB during the study period. A total of 298 HCWs met our definition for exposure. Exposed HCWs tended to be female (62.9%), non-Saudi (83.9%), nurses (68.6%), or respiratory therapists (24.0%) working in critical care locations (72.8%). Baseline (preemployment) TST documentation existed for 41.3% (123/298). Among those with documented baseline TSTs, 51.2% (63/123) were positive, representing 21....
… and Bioterrorism: Biodefense Strategy, Practice, and …, 2006
In addition to providing potable drinking water, US water systems are critical to the maintenance... more In addition to providing potable drinking water, US water systems are critical to the maintenance of many vital public services, such as fire suppression and power generation. Disruption of these sys-tems would produce severe public health and safety risks, as well as considerable ...
… and Bioterrorism: Biodefense Strategy, Practice, and …, 2006
In addition to providing potable drinking water, US water systems are critical to the maintenance... more In addition to providing potable drinking water, US water systems are critical to the maintenance of many vital public services, such as fire suppression and power generation. Disruption of these sys-tems would produce severe public health and safety risks, as well as considerable ...
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