TB Notes Newsletter
No. 1, 2007
Oral Presentation at the 2007 IUATLD
North America Region Conference
Sekai Chideya, MD, of DTBE’s International Research and Programs Branch,
developed an oral and poster presentation on the “Burden of Tuberculosis
Disease Among Marshall Islanders Living in Arkansas—2000–2005”
for the 2007 Conference of the International Union Against Tuberculosis and
Lung Disease (IUATLD), North America Region. Her colleague on the
study, Dr. Leonard Mukasa from the Arkansas Department of Health and Human Services,
presented the study at the conference. A brief synopsis of the study
is summarized below.
Although Native Hawaiians/Pacific Islanders (including Marshall Islanders)
account for only 0.1% of the population of Arkansas (AR), Marshall Islanders
represented 5.8% of all TB patients in the state during 2000–2005, and 40% of
foreign-born patients in 2004. This talk will describe factors influencing
TB transmission and barriers to care in Arkansas’ Marshall Islander community. Dr. Chideya
and her team reviewed Arkansas’ surveillance data for all TB cases and collected patient
data from medical records and interviews with Marshallese TB patients begun
on treatment January 1, 2000–December 31, 2005.
Of the 861 TB cases reported in Arkansas, 50 (5.8%) occurred
in Marshallese patients; 46 (92%) of the 50 patients were born in the Marshall Islands, yet only three (8%) reported
symptoms before U.S.
entry. Most (68%) lacked health insurance, and at least 10 (20%) had a
history of untreated or inadequately treated latent TB infection (LTBI). Among
the 40 symptomatic patients, 26 (65%) had delayed diagnosis (>60 days from
symptom onset to diagnosis), primarily due to patients not seeking medical attention,
misunderstanding the U.S. health care system, and having language and transportation
barriers.
Arkansas’ Marshall Islanders are
disproportionately affected by TB compared to other racial/ethnic groups. Promptly
identifying and treating LTBI, increasing access to medical insurance, and addressing
social and infrastructure-related barriers to health care will be vital in improving
prevention and control of TB and reducing health disparities in this population.
—Submitted by Bryan Kim, MPH
Div of TB Elimination
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