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Tuberculosis Epidemiologic Studies Consortium (TBESC)
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
- Describe the epidemiology of TB among persons in the United
States and Canada who were born outside either country.
- Determine the proportion of TB cases in foreign-born persons
for which improvements in case finding and treatment for active
disease are needed.
- Determine the proportion of TB cases in foreign-born persons
that were potentially preventable by improved contact
investigation after immigration.
- 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
Enrollment at most sites ended on December 31, 2006. The study
has already exceeded its initial enrollment goal of 1500 as the
final data set will include approximately 1700 participants. Task
Order 9 is currently completing collection of data from existing
surveillance and immigration databases that will supplement the
interview data. A codebook has been drafted and data cleaning is
underway. Eight working groups are developing outlines for the eight
initial proposed papers from the study.
Last Modified: 07/25/2007
Last Reviewed: 05/18/2008 Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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