Free Content Missed opportunities to prevent tuberculosis in foreign-born persons, Connecticut, 2005–2008

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SETTING: Factors that influence testing for latent tuberculosis infection (LTBI) among foreign-born persons in Connecticut are not well understood.

OBJECTIVE: To identify predictors for LTBI testing and challenges related to accessing health care among the foreign-born population in Connecticut.

DESIGN: Foreign-born Connecticut residents with confirmed or suspected tuberculosis (TB) disease during June 2005–December 2008 were interviewed regarding health care access and immigration status. Predictors for self-reported testing for LTBI after US entry were determined.

RESULTS: Of 161 foreign-born persons interviewed, 48% experienced TB disease within 5 years after arrival. One third (51/156) reported having undergone post-arrival testing for LTBI. Although those with established health care providers were more likely to have reported testing (aOR 4.49, 95%CI 1.48–13.62), only 43% of such persons were tested. Undocumented persons, the majority of whom lacked a provider (53%), were less likely than documented persons to have reported testing (aOR 0.20, 95%CI 0.06–0.67). Hispanic permanent residents (immigrants and refugees) and visitors (persons admitted temporarily) were more likely than non-Hispanics in the respective groups to have reported testing (OR 5.25, 95%CI 1.51–18.31 and OR 7.08, 95%CI 1.30–38.44, respectively).

CONCLUSIONS: The self-reported rate of testing for LTBI among foreign-born persons in Connecticut with confirmed or suspected TB was low and differed significantly by ethnicity and immigration status. Strategies are needed to improve health care access for foreign-born persons and expand testing for LTBI, especially among non-Hispanic and undocumented populations.

Keywords: immigrants; latent tuberculosis infection; vulnerable population

Document Type: Regular Paper


Affiliations: 1: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; Connecticut Department of Public Health, Hartford, Connecticut, USA 2: Connecticut Department of Public Health, Hartford, Connecticut, USA 3: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Publication date: August 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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