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Tuberculosis Epidemiologic Studies Consortium (TBESC)

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Task Order 9: Missed opportunities for TB prevention in foreign-born population in the United States and Canada

Task Order 9 aims to describe the epidemiology of TB in foreign-born persons in the United States and Canada and identify missed opportunities for prevention. This will be the first multi-state population-based epidemiologic study of TB in the foreign-born. Data obtained from this study will be used to identify interventions that can improve TB control activities and inform public health efforts to eliminate TB among foreign-born persons in the U.S. and Canada.

Sites

Broward County Health Department, FL; Seattle King County Health Department, WA, University of British Columbia, University of Manitoba, Minnesota State Health Department, American Lung Association of Metropolitan Chicago, New York State Health Department, Massachusetts State Health Department, Charles Felton TB Center in Harlem NY, University of Medicine and Dentistry New Jersey, Maryland State Health Department, Research Triangle Institute, Emory University, University of Alabama Birmingham, Tennessee State Health Department, Arkansas State Health Department, Texas State Health Department, University of North Texas Health Science Center Fort Worth, Denver Health and Hospitals Authority, University of California San Francisco, California State Health Department, and Hawaii State Health Department.

Study Objectives

  1. Describe the epidemiology of TB among persons in the United States and Canada who were born outside either country.
  2. Determine the proportion of TB cases in foreign-born persons for which improvements in case finding and treatment for active disease are needed.
  3. Determine the proportion of TB cases in foreign-born persons that were potentially preventable by improved contact investigation after immigration.
  4. Determine the proportion of cases that were potentially preventable by improved targeted testing and treatment for latent TB infection (LTBI).

Study Design

This will be a prospective, population-based study of the epidemiology of incident TB in foreign-born persons in the United States and Canada. Participants will be randomly selected from among all cases of TB in foreign-born persons reported in the catchment areas of the 22 Tuberculosis Epidemiologic Studies Consortium (TBESC) sites and in Broward County, Florida, in 2003-2004. Data will be collected via interviews with patients, abstraction of data from health department records and national surveillance databases, and matching with data collected by the CDC’s Division of Global Migration and Quarantine. Epidemiologic data collected will describe each case’s immigration status, means of diagnosis (through screening or due to symptomatic disease), country of origin, time from arrival to disease onset to diagnosis and initiation of treatment, migration in the U.S. or Canada, access/barriers to care (including insurance coverage and cultural barriers), treatment outcomes, and other information that will shed light on missed opportunities for prevention.

Study Progress

Data collection and cleaning has concluded. Data analysis is underway.

 
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