Latent tuberculosis infection screening in foreign-born populations: a successful mobile clinic outreach model

Am J Public Health. 2014 Aug;104(8):1508-15. doi: 10.2105/AJPH.2014.301897. Epub 2014 Jun 12.

Abstract

Objectives: We evaluated the efficacy of a mobile medical clinic (MMC) screening program for detecting latent tuberculosis infection (LTBI) and active tuberculosis.

Methods: A LTBI screening program in a MMC in New Haven, Connecticut, used medical surveys to examine risk factors and tuberculin skin test (TST) screening eligibility. We assessed clinically relevant correlates of total (prevalent; n = 4650) and newly diagnosed (incident; n = 4159) LTBI from 2003 to 2011.

Results: Among 8322 individuals, 4159 (55.6%) met TST screening eligibility criteria, of which 1325 (31.9%) had TST assessed. Similar to LTBI prevalence (16.8%; 779 of 4650), newly diagnosed LTBI (25.6%; 339 of 1325) was independently correlated with being foreign-born (adjusted odds ratio [AOR] = 8.49; 95% confidence interval [CI] = 5.54, 13.02), Hispanic (AOR = 3.12; 95% CI = 1.88, 5.20), Black (AOR = 2.16; 95% CI = 1.31, 3.55), employed (AOR = 1.61; 95% CI = 1.14, 2.28), and of increased age (AOR = 1.04; 95% CI = 1.02, 1.05). Unstable housing (AOR = 4.95; 95% CI = 3.43, 7.14) and marijuana use (AOR = 1.57; 95% CI = 1.05, 2.37) were significantly correlated with incident LTBI, and being male, heroin use, interpersonal violence, employment, not having health insurance, and not completing high school were significantly correlated with prevalent LTBI.

Conclusions: Screening for TST in MMCs successfully identifies high-risk foreign-born, Hispanic, working, and uninsured populations and innovatively identifies LTBI in urban settings.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Connecticut / epidemiology
  • Continental Population Groups / statistics & numerical data
  • Emigrants and Immigrants* / statistics & numerical data
  • Female
  • Humans
  • Latent Tuberculosis / diagnosis*
  • Latent Tuberculosis / epidemiology
  • Male
  • Mass Screening / methods
  • Mobile Health Units / organization & administration*
  • Prevalence
  • Risk Factors
  • Substance-Related Disorders / epidemiology
  • Tuberculin Test / methods