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Am J Public Health. 2014 Apr;104(4):e95-e102. doi: 10.2105/AJPH.2013.301637. Epub 2014 Feb 13.

Prevalence and treatment of latent tuberculosis infection among newly arrived refugees in San Diego County, January 2010-October 2012.

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At the time of the study, Rachel J. Bennett and Jill Waalen were with the Department of Family and Preventive Medicine, University of California, San Diego. Stephanie Brodine was with the Department of Epidemiology, Graduate School of Public Health, San Diego State University, San Diego. Kathleen Moser was with the Tuberculosis Control and Refugee Health Branch, San Diego County Health and Human Services Agency, San Diego. Timothy C. Rodwell was with the Department of Medicine, University of California, San Diego.



We determined the prevalence and treatment rates of latent tuberculosis infection (LTBI) in newly arrived refugees in San Diego County, California, and assessed demographic and clinical characteristics associated with these outcomes.


We analyzed data from LTBI screening results of 4280 refugees resettled in San Diego County between January 2010 and October 2012. Using multivariate logistic regression, we calculated the associations between demographic and clinical risk factors and the outcomes of LTBI diagnosis and LTBI treatment initiation.


The prevalence of LTBI was highest among refugees from sub-Saharan Africa (43%) and was associated with current smoking and having a clinical comorbidity that increases the risk for active tuberculosis. Although refugees from sub-Saharan Africa had the highest prevalence of infection, they were significantly less likely to initiate treatment than refugees from the Middle East. Refugees with postsecondary education were significantly more likely to initiate LTBI treatment.


Public health strategies are needed to increase treatment rates among high-risk refugees with LTBI. Particular attention is required among refugees from sub-Saharan Africa and those with less education.

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