Determining TB rates and TB case burden for refugees
OBJECTIVES: To calculate and compare tuberculosis (TB) rates in refugees to US-born, total foreign-born (refugee and other), and other foreign-born persons and to determine the contribution of refugees to the county TB case burden.
METHODS: The study included: 1) collection of county TB case numbers and population figures from 1995 through 1999; 2) estimation of the refugee population; 3) comparison of TB rates; and 4) calculation of the refugee TB case burden. Sensitivity analysis was performed on refugee population estimates.
RESULTS: From 1995 through 1999, estimating that refugees made up 10% of the foreign-born population, the average TB rate for refugees was 83.2 per 100000, compared with 12.7 for US-born persons. From 1997 through 1999, refugees had a seven-fold greater risk of having TB than US-born persons and a two-fold greater risk than other foreign-born persons. Refugees represented respectively 7.6% and 19.3% of the county and foreign-born TB case burdens. For TB rates to be equal among all foreign-born persons, refugees would need to make up 15–25% of the foreign-born population.
CONCLUSION: Despite overseas screening, refugees have high TB rates, and contribute substantially to the county TB case burden. Enhanced surveillance and targeted programs to address TB in refugees should be a public health priority.
Document Type: Regular Paper
Affiliations: 1: Refugee Health and Tuberculosis Program, DeKalb County Board of Health, Decatur, Georgia, USA 2: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Publication date: 2005-04-01
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