{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T03:13:30Z","timestamp":1775013210621,"version":"3.50.1"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>U.S. health departments routinely conduct post-arrival evaluation of immigrants and refugees at risk for tuberculosis (TB), but this important intervention has not been thoroughly studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess outcomes of the post-arrival evaluation intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We categorized at-risk immigrants and refugees as having had recent completion of treatment for pulmonary TB disease overseas (including in Mexico and Canada); as having suspected TB disease (chest radiograph\/clinical symptoms suggestive of TB) but negative culture results overseas; or as having latent TB infection (LTBI) diagnosed overseas. Among 2.1 million U.S.-bound immigrants and refugees screened for TB overseas during 2013\u20132016, 90,737 were identified as at risk for TB. We analyzed a national data set of these at-risk immigrants and refugees and calculated rates of TB disease for those who completed post-arrival evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 4,225 persons with recent completion of treatment for pulmonary TB disease overseas, 3,005 (71.1%) completed post-arrival evaluation within 1 year of arrival; of these, TB disease was diagnosed in 22 (732 cases\/100,000 persons), including 4 sputum culture\u2013positive cases (133 cases\/100,000 persons), 13 sputum culture\u2013negative cases (433 cases\/100,000 persons), and 5 cases with no reported sputum-culture results (166 cases\/100,000 persons). Among 55,938 with suspected TB disease but negative culture results overseas, 37,089 (66.3%) completed post-arrival evaluation; of these, TB disease was diagnosed in 597 (1,610 cases\/100,000 persons), including 262 sputum culture\u2013positive cases (706 cases\/100,000 persons), 281 sputum culture\u2013negative cases (758 cases\/100,000 persons), and 54 cases with no reported sputum-culture results (146 cases\/100,000 persons). Among 30,574 with LTBI diagnosed overseas, 18,466 (60.4%) completed post-arrival evaluation; of these, TB disease was diagnosed in 48 (260 cases\/100,000 persons), including 11 sputum culture\u2013positive cases (60 cases\/100,000 persons), 22 sputum culture\u2013negative cases (119 cases\/100,000 persons), and 15 cases with no reported sputum-culture results (81 cases\/100,000 persons). Of 21,714 persons for whom treatment for LTBI was recommended at post-arrival evaluation, 14,977 (69.0%) initiated treatment and 8,695 (40.0%) completed treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Post-arrival evaluation of at-risk immigrants and refugees can be highly effective. To optimize the yield and impact of this intervention, strategies are needed to improve completion rates of post-arrival evaluation and treatment for LTBI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201908-623oc","type":"journal-article","created":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T13:18:07Z","timestamp":1596115087000},"page":"1401-1412","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":22,"title":["Tuberculosis among Newly Arrived Immigrants and Refugees in the United States"],"prefix":"10.1093","volume":"17","author":[{"given":"Yecai","family":"Liu","sequence":"first","affiliation":[{"name":"Division of Global Migration and Quarantine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina R.","family":"Phares","sequence":"additional","affiliation":[{"name":"Division of Global Migration and 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