Tuberculosis prevention among foreign-born persons in Seattle--King County, Washington

Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):573-7. doi: 10.1164/ajrccm.156.2.9611101.


The purpose of this study was to evaluate the outcomes of classified immigrant and refugee (I&R) screening and of contact investigation (CI) of foreign-born TB cases in Seattle--King County (SKC), Washington. We reviewed I&R evaluations from the SKC TB clinic for 1992-1994 and contact evaluation records for 54 randomly selected U.S.-born and foreign-born pulmonary TB patients from 1993. Among 942 I&R evaluated, 693 (74%) had positive tuberculin skin tests (TST). Preventive therapy (PT) was prescribed for 324 (34%) and treatment for 49 (5%). The remaining 377 were dismissed, of whom 96% did not meet American Thoracic Society PT criteria. Contacts of foreign-born cases were more numerous (6.0 versus 3.4 per case, p = 0.04), and significantly more likely to be TST-positive (50% versus 18%) and to be started on PT (40% versus 23%). The large number of I&R eligible for treatment or PT emphasizes the benefit of prompt evaluation of new arrivals. CI provides an excellent opportunity to screen foreign-born persons at high risk for active TB.

Publication types

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

MeSH terms

  • Contact Tracing / statistics & numerical data
  • Emigration and Immigration* / statistics & numerical data
  • Humans
  • Mass Chest X-Ray / statistics & numerical data
  • Random Allocation
  • Refugees* / statistics & numerical data
  • Tuberculin Test / statistics & numerical data
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / ethnology
  • Tuberculosis, Pulmonary / prevention & control*
  • Urban Population* / statistics & numerical data
  • Washington / epidemiology