Tuberculosis

Abstract

Despite overall success in tuberculosis (TB) control in the United States, TB continues to be a global problem, reflected in the fact that incident cases of active TB among foreign-born people in the United States are 15 times higher than that of native-born people. As a result, for those applying for refugee status in the United States, the Centers for Disease Control and Prevention Division of Global Migration and Quarantine requires a predeparture medical evaluation that, among other things, is designed to identify people with active, infectious tuberculosis disease. The domestic tuberculosis screening of settled refugees is largely focused on identification and treatment of latent tuberculosis infection (LTBI), but also serves to identify missed or recently-developed active TB disease. Thus, the US-based physician has an important role in screening newly arrived refugees for LTBI and tuberculosis disease. This chapter reviews LTBI and tuberculosis disease screening and treatment regimens.