December 5, 2002 (The Associated Press) -- Screening and treating immigrants from developing countries for dormant tuberculosis infections would prevent thousands of cases and save tens of millions of dollars, a study shows.
While the number of TB cases in the United States has been dropping, immigrants account for a growing proportion of them. There were nearly 16,000 U.S. cases last year and about half were in foreign-born residents, up from 27 percent a decade earlier.
Potential immigrants now get a chest X-ray to detect active TB, and those who are sick are required to get treatment. The Institute of Medicine has recommended a skin test for inactive, or latent, infections also be given to those from countries where TB is common.
A study in Thursday's New England Journal of Medicine looked at whether such a practice would be cost-effective. Using immigration figures from 2000, researchers in New York calculated all the costs of screening and treating immigrants when they enter the country. They compared that to the cost of treating the active TB cases that would eventually arise if nothing was done.
The researchers estimated that screening and treating dormant infections for a single year would prevent between 9,000 and 10,000 active TB cases and save $60 million to $90 million.
"This is a wake-up call that, yes, tuberculosis is a preventable disease," said Dr. Lee B. Reichman, executive director of the New Jersey Medical School National Tuberculosis Center.
He said the challenge is to get doctors to recognize that and test their patients for latent TB and treat them. If screening of immigrants is adopted, "then we can really make a dent in the tuberculosis problem," Reichman said.
TB is an airborne disease and only those in active stages are contagious.
The study also compared different antibiotics, taking into account drug-resistance in each country or region. Researcher Dr. Kamran Khan, now at St. Michael's Hospital at the University of Toronto, said the information can be used to tailor treatment for immigrants.
"Infectious diseases move without borders, and we really need medicines to be able to address that fact," Khan said.
Copyright 2002 The Associated Press. All rights reserved.
