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Am J Public Health. 2014 Aug;104(8):1508-15. doi: 10.2105/AJPH.2014.301897. Epub 2014 Jun 12.

Latent tuberculosis infection screening in foreign-born populations: a successful mobile clinic outreach model.

Author information

1
Jamie P. Morano, Alexei Zelenev, Mary R. Walton, R. Douglas Bruce, and Frederick L. Altice are with the Yale School of Medicine, Department of Infectious Diseases, Yale University AIDS Program, New Haven, CT. R. D. Bruce and F. L. Altice are also affiliated with the Yale School of Public Health, Division of Epidemiology of Microbial Diseases, New Haven. F. L. Altice is also associated with the Centre of Excellence in Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia.

Abstract

OBJECTIVES:

We evaluated the efficacy of a mobile medical clinic (MMC) screening program for detecting latent tuberculosis infection (LTBI) and active tuberculosis.

METHODS:

A LTBI screening program in a MMC in New Haven, Connecticut, used medical surveys to examine risk factors and tuberculin skin test (TST) screening eligibility. We assessed clinically relevant correlates of total (prevalent; n = 4650) and newly diagnosed (incident; n = 4159) LTBI from 2003 to 2011.

RESULTS:

Among 8322 individuals, 4159 (55.6%) met TST screening eligibility criteria, of which 1325 (31.9%) had TST assessed. Similar to LTBI prevalence (16.8%; 779 of 4650), newly diagnosed LTBI (25.6%; 339 of 1325) was independently correlated with being foreign-born (adjusted odds ratio [AOR] = 8.49; 95% confidence interval [CI] = 5.54, 13.02), Hispanic (AOR = 3.12; 95% CI = 1.88, 5.20), Black (AOR = 2.16; 95% CI = 1.31, 3.55), employed (AOR = 1.61; 95% CI = 1.14, 2.28), and of increased age (AOR = 1.04; 95% CI = 1.02, 1.05). Unstable housing (AOR = 4.95; 95% CI = 3.43, 7.14) and marijuana use (AOR = 1.57; 95% CI = 1.05, 2.37) were significantly correlated with incident LTBI, and being male, heroin use, interpersonal violence, employment, not having health insurance, and not completing high school were significantly correlated with prevalent LTBI.

CONCLUSIONS:

Screening for TST in MMCs successfully identifies high-risk foreign-born, Hispanic, working, and uninsured populations and innovatively identifies LTBI in urban settings.

PMID:
24922157
PMCID:
PMC4103248
DOI:
10.2105/AJPH.2014.301897
[Indexed for MEDLINE]
Free PMC Article

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