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• W2039787568 abstract "<h3>Objective.</h3> —To study screening outcomes among a group of Tibetan immigrants at high risk for developing active tuberculosis (TB) after arrival in Minnesota. <h3>Design.</h3> —Retrospective cohort study. <h3>Participants.</h3> —A total of 191 Tibetan immigrants undergoing medical screening. <h3>Main Outcome Measures.</h3> —Occurrence and treatment outcomes of active TB. <h3>Setting.</h3> —A health maintenance organization and a public TB clinic in Minneapolis, Minn. <h3>Results.</h3> —Positive (induration, ≥10 mm) tuberculin skin test results were documented in 98% of Tibetans, compared with 44% of Vietnamese, 10% of Hmong, and 51% of Russian refugees in Minnesota (<i>P</i><.001 for each group). Sixteen active cases (8.4%) were confirmed by isolation of<i>Mycobacterium tuberculosis</i>; however, 5 (31%) were culture-negative on initial screening in Minnesota. Seven cases (44%) were diagnosed during initial screening efforts, and 9 cases (56%) were diagnosed a mean of 19 months (range, 10-27 months) after their initial medical evaluation. Of these 9 cases, 6 (38% of all Tibetan cases) had isolates resistant to 1 or more antituberculous drugs, and 3 (19% of all Tibetan cases) were multidrug resistant (MDR TB). All 3 MDR TB cases were culture-negative on initial screening; these cases constituted 75% of the MDR TB isolates in Minnesota in 1994. The presence of MDR TB was associated with a known history of active TB in Asia (<i>P</i><.02). Any abnormality on chest radiograph noted either during the Immigration and Naturalization Service screening evaluation in India (relative risk [RR], 5.2;<i>P</i>=.006) or on arrival in Minnesota (RR, 6.8;<i>P</i>=.005) was associated with an increased risk of subsequent active TB. <h3>Conclusions.</h3> —Tuberculosis infection is nearly universal among Tibetans settling in Minnesota. A single screening evaluation failed to detect the majority of TB cases among Tibetans. Even in the face of negative<i>M tuberculosis</i>cultures, persons with a history of active TB require particularly close follow-up." @default.
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• W2039787568 date "1997-03-05" @default.
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• W2039787568 title "Tuberculosis Among Tibetan Immigrants From India and Nepal in Minnesota, 1992-1995" @default.
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• W2039787568 doi "https://doi.org/10.1001/jama.1997.03540330057035" @default.
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