Post-arrival tuberculosis screening at a local health department of high-risk immigrants

Post Date: 
American Journal of Public Health

Objectives: We sought to characterize postimmigration tuberculosis (TB) care for Class B immigrants and refugees at the Baltimore City Health Department TB program (BCHD), and to determine the proportion of immigrants with active TB or latent TB infection (LTBI) in this high-risk population.

Methods: We conducted a retrospective chart review of Class B immigrants and refugees who reported to the BCHD for postimmigration TB evaluation from 2010 to 2012.

Results: We reviewed the clinical records of 153 Class B immigrants; 4% were diagnosed with active TB and 53% were diagnosed with LTBI. Fifty percent of active TB cases were culture positive, and 67% were asymptomatic; 100% received and completed active TB therapy at the BCHD. Among those diagnosed with LTBI, 87% initiated LTBI therapy and 91% completed treatment.


The high prevalence of active TB and LTBI found among Class B immigrants underscore the importance for postarrival TB screening. The absence of reported symptoms among the majority of active cases identified during this study suggest that reliance on symptom-based screening protocols to prompt sputa testing may be inadequate for identifying active TB among this high-risk group.

Nuzzo J, Golub J, Chaulk P, Shah M. Post-arrival tuberculosis screening at a local health department of high-risk immigrants. Am J Public Health. 2015 Jul;105(7):1432-8. doi: 10.2105/AJPH.2014.302287. PMID: 25602872; PMCID: PMC4463376.

  • Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

  • UPMC Center for Health Security, Baltimore, MD

  • Baltimore City Health Department, Baltimore, MD