Multidrug-Resistant Tuberculosis Outbreak among Hmong Refugees
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)
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