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Even affluent immigrants in U.S. at TB risk: study

Last Updated: 2003-05-28 16:39:21 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Although tuberculosis is often associated with poverty, a New Jersey study released Wednesday shows immigrants with TB are not necessarily poor and many live in relatively well-to-do areas.

The researchers recommend that some funds be reallocated to combat TB in more affluent areas.

"An epidemic of TB among young foreign-born residents living in relatively affluent areas of New Jersey flies in the face of long-held stereotypes regarding the socioeconomics of TB overall and in particular among the foreign-born," Dr. Amy L. Davidow and her colleagues write in the American Journal of Public Health.

"This observation especially applies to immigrants from Asian and South Asian countries, who constitute 43.6 percent of foreign-born TB patients in New Jersey," they add.

Davidow, who is with the New Jersey Medical School National Tuberculosis Center in Newark, and colleagues evaluated TB rates in New Jersey between 1994 and 1999. Using zip codes and other factors the team determined the socioeconomic status for each person with the respiratory ailment.

In all, 4,295 TB cases were reported, with 2,005 (47 percent) of TB cases occurring among immigrants. Of those, 27 percent lived in affluent areas compared with 18 percent of U.S.-born patients, the authors report.

Davidow's team estimates that at current rates, New Jersey can expect 300 new TB cases among foreign-born residents annually, with one third residing in relatively affluent neighborhoods.

Currently the Centers for Disease Control and Prevention recommends that immigrants from countries with high rates of tuberculosis -- including India, China, Bangladesh, Indonesia and Pakistan -- be screened for active and latent tuberculosis infection when they enter the healthcare system.

Caused by an airborne bacterium, tuberculosis is characterized by coughing, fever and weight loss. Illness can occur years after exposure to the bacterium. Patients must take anti-TB drugs for months, since those who stop early may not be cured.

Tuberculosis is the second-leading infectious cause of death worldwide. Approximately 2 million people die each year from tuberculosis and an estimated 2 billion people are infected with the bacterium that causes the respiratory ailment.

Overall, tuberculosis cases are on the decline in the United States, but the infection rate is not dropping as quickly among immigrants.

Copyright 2002 Reuters.