Journal of Immigrant and Minority Health

, Volume 15, Issue 4, pp 673–679

Impact of Port of Entry Referrals on Initiation of Follow-Up Evaluations for Immigrants with Suspected Tuberculosis: Illinois

  • Teal R. Bell
  • NoelleAngelique M. Molinari
  • Sena Blumensaadt
  • Monica U. Selent
  • Michael Arbisi
  • Neha Shah
  • Demian Christiansen
  • Rossanne Philen
  • Benjamin Puesta
  • Joshua Jones
  • Deborah Lee
  • Arnold Vang
  • Nicole J. Cohen
Original Paper

DOI: 10.1007/s10903-013-9779-7

Cite this article as:
Bell, T.R., Molinari, N.M., Blumensaadt, S. et al. J Immigrant Minority Health (2013) 15: 673. doi:10.1007/s10903-013-9779-7
  • 134 Downloads

Abstract

US-bound immigrants with suspected non-infectious TB are encouraged to be medically re-evaluated after arrival in the United States. We evaluated the Centers for Disease Control and Prevention’s immigrant referral process, designed to facilitate timely post-arrival evaluations. Over 1,200 immigrants with suspected TB arriving during October 1, 2008–September 30, 2010 were identified. In 2011, differences in days to evaluation initiation were assessed by referral type using survival analysis and Cox proportional hazard models. Among those receiving any referral, median time to post-arrival evaluation was significantly lower compared with immigrants receiving no referral (16 vs. 69 days, respectively; p < 0.0001). After adjusting for the covariates, immigrants receiving any referral initiated follow-up at 4 times the rate (adjusted hazard ratio = 4.0; p < 0.0001) of those receiving no referral. Implementing a referral system at US ports of entry will improve timeliness and increase the proportion of immigrants initiating domestic evaluation.

Keywords

EvaluationTuberculosisReferralImmigrants

Copyright information

© Springer Science+Business Media New York (Outside the USA) 2013

Authors and Affiliations

  • Teal R. Bell
    • 1
    • 2
  • NoelleAngelique M. Molinari
    • 1
  • Sena Blumensaadt
    • 1
  • Monica U. Selent
    • 1
  • Michael Arbisi
    • 3
  • Neha Shah
    • 1
  • Demian Christiansen
    • 5
  • Rossanne Philen
    • 1
  • Benjamin Puesta
    • 1
  • Joshua Jones
    • 4
  • Deborah Lee
    • 1
  • Arnold Vang
    • 1
  • Nicole J. Cohen
    • 1
  1. 1.Division of Global Migration and QuarantineCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Council of State and Territorial EpidemiologistsAtlantaUSA
  3. 3.Division of Infectious DiseasesIllinois Department of Public HealthSpringfieldUSA
  4. 4.Tuberculosis Control ProgramChicago Department of Public HealthChicagoUSA
  5. 5.Communicable Disease Control UnitCook County Department of Public HealthChicagoUSA