Emerging Infectious Diseases (Mar 2022)

Overseas Treatment of Latent Tuberculosis Infection in US–Bound Immigrants

  • Amera Khan,
  • Christina R. Phares,
  • Hoang Lan Phuong,
  • Dang Thi Kieu Trinh,
  • Ha Phan,
  • Cindy Merrifield,
  • Phan Thi Hong Le,
  • Quach Thi Kim Lien,
  • Sooc Ngoc Lan,
  • Phan Thi Kim Thoa,
  • Le Tran Minh Thu,
  • Tiffany Tran,
  • Cuc Tran,
  • Lucy Platt,
  • Susan A. Maloney,
  • Nguyen Viet Nhung,
  • Payam Nahid,
  • John E. Oeltmann

DOI
https://doi.org/10.3201/eid2803.212131
Journal volume & issue
Vol. 28, no. 3
pp. 582 – 590

Abstract

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Seventy percent of tuberculosis (TB) cases in the United States occur among non–US-born persons; cases usually result from reactivation of latent TB infection (LTBI) likely acquired before the person’s US arrival. We conducted a prospective study among US immigrant visa applicants undergoing the required overseas medical examination in Vietnam. Consenting applicants >15 years of age were offered an interferon-γ release assay (IGRA); those 12–14 years of age received an IGRA as part of the required examination. Eligible participants were offered LTBI treatment with 12 doses of weekly isoniazid and rifapentine. Of 5,311 immigrant visa applicants recruited, 2,438 (46%) consented to participate; 2,276 had an IGRA processed, and 484 (21%) tested positive. Among 452 participants eligible for treatment, 304 (67%) initiated treatment, and 268 (88%) completed treatment. We demonstrated that using the overseas medical examination to provide voluntary LTBI testing and treatment should be considered to advance US TB elimination efforts.

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