Cultural case management of latent tuberculosis infection

Int J Tuberc Lung Dis. 2004 Jan;8(1):76-82.


Setting: The proportion of tuberculosis (TB) among foreign-born individuals in the United States is steadily increasing. Treatment of latent TB infection can prevent future cases of disease, although generally only 60% of patients who start a 6-month regimen of isoniazid complete therapy.

Objective: Cultural case management--employing case manager cultural mediators who serve patient-defined needs in addition to performing TB control functions--may improve results of testing and treatment in one high-risk group, new refugees.

Design: A cultural case management approach was established for finding and treating latent TB infection among three groups of new refugees: from the former Soviet Union (FSU), former Yugoslavia (FY), and Somalia.

Results: From July 1999 through December 2000, treatment was offered to 442 refugees, of whom 389 (88%) started and 319 (82%) completed therapy. The completion rate among starters from the FSU was 76%, for those from FY it was 94% and for those from Somalia it was 88%. Among all refugees to whom treatment was offered, 319/442 (72%) completed therapy.

Conclusion: Cultural case management may be a useful tool for expanding treatment of latent TB infection among foreign-born individuals.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Antitubercular Agents / administration & dosage*
  • Attitude to Health / ethnology
  • Case Management*
  • Cohort Studies
  • Communicable Disease Control / organization & administration*
  • Cultural Diversity
  • Emigration and Immigration*
  • Female
  • Health Education / organization & administration
  • Humans
  • Male
  • Probability
  • Program Development
  • Program Evaluation
  • Risk Assessment
  • Severity of Illness Index
  • Tuberculin Test
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy*
  • Tuberculosis / ethnology*
  • United States / epidemiology


  • Antitubercular Agents