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Health-care barriers for undocumented immigrants: Raising tuberculosis risk?
Date:10/29/2008

A new study raises the question, do barriers to health care for undocumented immigrants increase the public health risk of tuberculosis? The study, published in the November 15, 2008 issue of Clinical Infectious Diseases and now available online, suggests that undocumented immigrants with tuberculosis have symptoms longer before seeking care than documented immigrants or U.S.-born patients, resulting in more severe symptoms and more opportunities for transmission. These findings raise questions about the value to both patients and the public of improving access to health care for undocumented immigrants.

Rates of tuberculosis are declining overall in the United States, but the proportion occurring among foreign-born persons is increasing and the case rate is almost 10 times higher than that among persons born in the United States. Furthermore, funding for tuberculosis elimination is declining, leading to concerns about a resurgence of the disease.

In a review of medical records for patients diagnosed with pulmonary tuberculosis at a New York City hospital between April 1999 and March 2005, the authors of this study investigated whether there were any differences in clinical presentation among U.S.-born, foreign-born and documented, or foreign-born and undocumented individuals. Of 194 patients with newly diagnosed pulmonary tuberculosis, 31 percent were U.S.-born, 32 percent were foreign-born and documented, and 37 percent were foreign-born and undocumented. Undocumented patients exhibited an increased frequency of cough, bloody expectoration, and a much longer duration of symptoms prior to hospitalization compared to U.S.-born patients.

The median symptom duration in undocumented patients was eight weeks, compared to four weeks in U.S.-born and documented foreign-born patients. The significantly higher frequency of cough combined with prolonged symptom duration in undocumented foreign-born individuals could potentially lea
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Contact: Steve Baragona
sbaragona@idsociety.org
703-299-0412
Infectious Diseases Society of America
Source:Eurekalert

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