Timing of Therapy for Latent Tuberculosis Infection Among Immigrants
Author Information
Author(s): Page Kathleen R, Manabe Yukari C, Adelakun Akintoye, Federline Lynn, Cronin Wendy, Campbell James D, Dorman Susan E
Primary Institution: Johns Hopkins University School of Medicine
Hypothesis
How does the timing of LTBI therapy among immigrants presenting to a public health clinic relate to their time of arrival in the U.S.?
Conclusion
Foreign-born individuals who are not referred for LTBI therapy through immigration proceedings are less likely to receive LTBI therapy within 5 years of arrival to the U.S.
Supporting Evidence
- 1882 immigrants received LTBI therapy at Prince Georges County Health Department between 1999 and 2004.
- 16% of all immigrants initiated therapy more than 5 years after arrival to the U.S.
- Referral for therapy by non-immigration proceedings was the strongest predictor of initiation of therapy more than 5 years after arrival.
Takeaway
This study shows that many immigrants wait too long to get treatment for a hidden TB infection, especially if they don't go through immigration services.
Methodology
Retrospective chart review of patients prescribed LTBI treatment based on medical records from Prince Georges County Health Department.
Potential Biases
Potential bias due to the assumption that most LTBI infections were acquired in the country of origin.
Limitations
The study was limited to one county TB control program in Maryland, which may affect the generalizability of the results.
Participant Demographics
The cohort was relatively young (median age 23 years) with a slight female predominance (54%). Most patients originated from Africa (57%), Latin America & the Caribbean (28%), and Asia (11%).
Statistical Information
Confidence Interval
95% CI 1.2–2.6 for female gender; 95% CI 2.5–6.6 for age ≥ 35; 95% CI 1.3–3.0 for Latin America and the Caribbean.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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