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J Travel Med. 2007 Jan-Feb;14(1):1-8.

The epidemiology of tuberculosis among primary refugee arrivals in Minnesota between 1997 and 2001.

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Division of Preventive and Occupational Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.



Minnesota (MN) is home to one of the highest number of refugees in the United States. The primary objective of this study was to evaluate the prevalence of latent and active tuberculosis (TB) infection in primary refugee arrivals to MN. Secondary objectives were to determine the association of TB infection with gender, age, and ethnicity of the refugees.


A retrospective study of primary refugee arrivals to MN between January 1, 1997, and December 31, 2001, was conducted. Chi-square tests and logistic regression analyses were used to assess the association of TB infection with gender, age, and ethnicity.


Of the 9,842 refugees who had Mantoux test results, 4,990 (50.7%) had a positive test. A positive test was more common in men [odds ratio (OR) = 1.6; p < 0.0001], in Africans (OR = 1.6, p = <0.0001), and increased with 10-year age intervals (OR = 1.4; p < 0.0001). A total of 116 (0.8%) refugees received treatment for active TB. Active TB was more common in men (OR = 1.7; p = 0.006), African ethnicity (OR = 4.3; p < 0.0001), and increased with 10-year age intervals (OR = 1.1; p = 0.05).


Screening and treatment for latent and active TB should be actively managed among refugees resettling in the United States, as this is common and can have significant public health implications.

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