Yecai Liu, MS; Drew L. Posey, MD, MPH; Martin S. Cetron, MD; John A. Painter, DVM, MS
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOf InterestForms.do?msNum=M14-2082.
Liu Y., Posey D., Cetron M., Painter J.; Tuberculosis Incidence in Immigrants and Refugees. Ann Intern Med. 2015;163:150-151. doi: 10.7326/L15-5111-2
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Published: Ann Intern Med. 2015;163(2):150-151.
Dr. Challa suggests several limitations of the data in our analysis, raising doubts about the effect of a newly implemented, overseas, culture-based TB screening algorithm on reducing the importation of this condition to the United States. We discussed some of these limitations in our article but have reached a different conclusion.
Newly arrived nonimmigrant visitors contribute to the TB burden in the United States (1). The mean annual admission of nonimmigrant visitors between 2007 and 2012 decreased by 8.5% compared with that between 2002 and 2006. However, during the same period, the mean annual number of reported TB cases among foreign-born persons within 1 year of arrival decreased by 24.7%. This discrepancy indicates that the decrease in admissions of nonimmigrant visitors alone could not account for the overall decline of TB cases in the newly arrived, foreign-born population.
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