Multidrug-Resistant Tuberculosis Outbreak among US-bound Hmong Refugees, Thailand, 2005
2008

Multidrug-Resistant Tuberculosis Outbreak among Hmong Refugees

Sample size: 272 publication 10 minutes Evidence: high

Author Information

Author(s): Oeltmann John E., Varma Jay K., Ortega Luis, Liu Yecai, O’Rourke Thomas, Cano Maria, Harrington Theresa, Toney Sean, Jones Warren, Karuchit Samart, Diem Lois, Rienthong Dhanida, Tappero Jordan W., Ijaz Kashef, Maloney Susan A.

Primary Institution: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Hypothesis

Enhanced pre-immigration screening and treatment will reduce the importation of tuberculosis among Hmong refugees.

Conclusion

Enhanced pre-immigration TB screening and treatment decreased the importation of tuberculosis cases among Hmong refugees.

Supporting Evidence

  • Before enhanced screening, 46 TB cases were diagnosed among 9,455 resettled refugees.
  • After enhanced screening, only 4 TB cases were found among 5,705 resettled refugees.
  • 20 out of 23 MDR TB isolates were similar according to molecular typing methods.

Takeaway

Some Hmong refugees had a serious type of tuberculosis that was hard to treat, but better health checks before they came to the U.S. helped stop more people from getting sick.

Methodology

The study involved enhanced TB screenings, patient interviews, and molecular typing of TB isolates.

Potential Biases

Potential bias in self-reported treatment history and social links among patients.

Limitations

The study did not include a control group for comparison of TB rates before and after enhanced screening.

Participant Demographics

{"total":272,"sex":{"female":112,"male":160},"age_distribution":{"under_15":21,"15_to_64":153,"over_65":98}}

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI 1.4–1.9

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.3201/eid1411.071629

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