{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:41:10Z","timestamp":1777898470128,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2014,7,1]],"date-time":"2014-07-01T00:00:00Z","timestamp":1404172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective.<\/jats:title>\n                    <jats:p>We validated cases of active tuberculosis (TB) recorded in the Indian Health Service (IHS) National Patient Information Reporting System (NPIRS) and evaluated the completeness of TB case reporting from IHS facilities to state health departments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>We reviewed the medical records of American Indian\/Alaska Native (AI\/AN) patients at IHS health facilities who were classified as having active TB using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes from 2006 to 2009 for clinical and laboratory evidence of TB disease. Individuals were reclassified as having active TB disease; recent latent TB infection (LTBI); past positive tuberculin skin test (TST) only; or as having no evidence of TB, LTBI, or a past positive TST. We compared validated active TB cases with corresponding state records to determine if they were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>The study included 596 patients with active TB as per ICD-9-CM codes. Based on chart review, 111 (18.6%) had active TB; 156 (26.2%) had LTBI; 104 (17.4%) had a past positive TST; and 221 (37.1%) had no evidence of TB disease, LTBI, or a past positive TST. Of the 111 confirmed cases of active TB, 89 (80.2%) resided in participating states; 81 of 89 (91.2%) were verified as reported TB cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>ICD-9-CM codes for active TB disease in the IHS NPIRS do not accurately reflect the burden of TB among AI\/ANs. Most confirmed active TB cases in the IHS health system were reported to the state; the national TB surveillance system may accurately represent the burden of TB in the AI\/AN population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/003335491412900410","type":"journal-article","created":{"date-parts":[[2017,7,4]],"date-time":"2017-07-04T15:17:56Z","timestamp":1499181476000},"page":"351-360","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Understanding the Burden of Tuberculosis among American Indians\/Alaska Natives in the U.S.: A Validation Study"],"prefix":"10.1177","volume":"129","author":[{"given":"Laura Jean","family":"Podewils","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Alexy","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA"},{"name":"Emory University, Rollins School of Public Health, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephani Jean","family":"Driver","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA"},{"name":"Emory University, Rollins School of Public Health, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E.","family":"Cheek","sequence":"additional","affiliation":[{"name":"Indian Health Service, Division of Epidemiology and Disease Prevention, Albuquerque, NM"},{"name":"University of New Mexico Health Sciences Center, Albuquerque, NM"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C.","family":"Holman","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Haberling","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan","family":"Brett","sequence":"additional","affiliation":[{"name":"Indian Health Service, Division of Epidemiology and Disease Prevention, Albuquerque, NM"},{"name":"University of New Mexico Health Sciences Center, Albuquerque, NM"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene","family":"McCray","sequence":"additional","affiliation":[{"name":"Indian Health Service, Santa Fe, NM"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John T.","family":"Redd","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Atlanta, GA"},{"name":"Indian Health Service, Santa Fe, NM"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,7,1]]},"reference":[{"key":"bibr1-003335491412900410","unstructured":"Centers for Disease Control and Prevention (US). Reported tuberculosis in the United States, 2011 Atlanta: CDC; 2012 Also available from: URL: http:\/\/www.cdc.gov\/tb\/statistics\/reports\/2011\/pdf\/report2011.pdf [cited 2013 Mar 5]."},{"key":"bibr2-003335491412900410","unstructured":"Centers for Disease Control and Prevention (US). National Notifiable Diseases Surveillance System (NNDSS): case definitions [cited 2013 Mar 5]. Available from: URL: http:\/\/wwwn.cdc.gov\/nndss\/script\/casedefDefault.aspx"},{"key":"bibr3-003335491412900410","unstructured":"Indian Health Service (IHS). Indian Health Service: quick look [cited 2014 Jan 31]. Available from: URL: http:\/\/www.ihs.gov\/newsroom\/factsheets\/quicklook"},{"key":"bibr4-003335491412900410","volume-title":"Direct\/CHS inpatient data: all diseases, fiscal years 1998\u20132006, National Patient Information Reporting System","author":"Indian Health Service (US)","year":"2009"},{"key":"bibr5-003335491412900410","unstructured":"National Center for Health Statistics, Centers for Medicare & Medicaid Services (US). International classification of diseases, ninth revision, clinical modification (ICD-9-CM) [cited 2013 Sep 14]. Available from: URL: http:\/\/www.cdc\/gov\/nchs\/icd\/icd9cm.htm"},{"key":"bibr6-003335491412900410","unstructured":"Indian Health Service (US). IHS EHR GUI deployment status [cited 2013 Apr 26]. Available from: URL: http:\/\/www.ihs.gov\/ehr\/index.cfm?module=gui_facilities"},{"key":"bibr7-003335491412900410","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(99)00011-3"},{"key":"bibr8-003335491412900410","doi-asserted-by":"publisher","DOI":"10.1002\/art.22544"},{"key":"bibr9-003335491412900410","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.07.011"},{"key":"bibr10-003335491412900410","doi-asserted-by":"publisher","DOI":"10.1177\/003335491012500611"},{"key":"bibr11-003335491412900410","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2049"},{"key":"bibr12-003335491412900410","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3243"},{"key":"bibr13-003335491412900410","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21959"},{"key":"bibr14-003335491412900410","unstructured":"Indian Health Service (IHS). Indian Health Service glossary [cited 2013 Mar 5]. 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