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Appendix - Sample Epidemiologic Profile

The following table (Table_A1) represents some elements of a tuberculosis (TB) profile for a foreign-born person that should be considered for use in state and local health departments.
Table_A1
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SAMPLE EPIDEMIOLOGIC PROFILE
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Data                          Sources                        How data will be used
-----------------------------------------------------------------------------------------------
Demographics
Patient's age at diagnosis    "Reports of Verified Cases     Targeting of programmatic
                              of Tuberculosis"               efforts
Patient's age at entry to
United States
Country of origin
Sex
Employed (Y/ N)
Years in United States at     "Reports of Verified Cases     Identification of at- risk
time of diagnosis             of Tuberculosis"               groups; identification of
                                                             missed opportunities for
                                                             prevention

Source case identified        Add to "Reports of Verified    Transmission in foreign-born
(especially in pediatric      Cases of Tuberculosis"         community; strategy for case
cases)                                                       finding

Clinical/ diagnostic          Add to "Reports of Verified    Program management;
- Previous treatment for TB   Cases of Tuberculosis"         issues surrounding delays in
(Past preventive treatment?)                                 diagnosis; issues regarding
- Acid- fast bacilli smear                                   treatment; issues regarding
- Acid- fast bacilli culture                                 preventive therapy;
- Drug susceptibility                                        advocacy; program planning
- HIV status

Case Management
Type of provider              "Reports of Verified Cases     Targeting provider education
                              of Tuberculosis"

Patient on directly observed  "Reports of Verified Cases     Patient management
therapy?                      of Tuberculosis"

Completion of therapy         Add to "Reports of Verified    Program management;
                              Cases of Tuberculosis"         identifying high- risk
                                                             patients;
                                                             targeting programs.

Drug regimen                  "Reports of Verified Cases     Program management
Drug resistance               Tuberculosis" and WHO

Case Finding
Screening program             State and local health         Evaluation of program
- Number screened             departments                    performance
- Number infected
- Cases found
- Preventive treatment
  completed

Contact tracing               CDC and state and local        Evaluation of program
- Done or not?                health departments             performance
- Number of contacts
  identified per case
- Number of cases with no
  contacts identified
- Number (%) infected with
  no disease
- Number (%) placed on
  preventive therapy
- Number (%) completed
  preventive therapy
- Cases found

Class B1/ B2 Cases
Number of notifications       CDC/ National Center for       Resource allocation
                              Infectious
                              Diseases/ Division of
                              Quarantine
Number investigated           CDC/ National Center for       Resource allocation
                              Infectious
                              Diseases/ Division of
                              Quarantine and state and
                              local health departments
Number eligible for           CDC/ National Center for       Prioritization of resources
prevention
Number with disease           Infectious
Number started on treatment   Diseases/ Division of
Number completed treatment    Quarantine and state and
                              local health departments

Civil Surgeon Referral
Number with status            U. S. Department of            Assessment of potential
readjusted                    Justice/ Immigration and       burden to health
                              Naturalization Service         department
Number eligible for           U. S. Department of            Resource allocation;
prevention
Number with disease           Justice/ Immigration and       advocacy for medical
Number referred to health     Naturalization Service and     services
department (asylees)          local health department

Qualitative Data on
Screening
Special studies               Local health departments       Program planning/ resource
- Schools/ universities                                      allocation; strategy for
                                                             case finding
- English- as- second-
  language schools
- Community- based
  organizations

Immigration Profile
Current population profiles   U. S. Census Bureau and        Program planning;
New immigration               U. S. Department of            resource allocation;
- Overseas immigrants         Justice/ Immigration and       advocacy for medical
- Adjustment of status        Naturalization Service         services
- Asylum seekers

Special Studies
Barriers to accessing care    State and local health         Issues regarding access -
- Language                    departments                    advocacy for medical
- Financial                                                  services
- Legal
- Cultural
- Knowledge
- Health beliefs

Patient versus provider       State and local health         Issues regarding early
delays                        departments                    diagnosis; patient and
- Duration of symptoms                                       provider education
  before diagnosis
- Number of visits made
  before diagnosis
- Type of provider

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