Schneider Diana L, Lobato Mark N
Division of Immigration Health Services, U.S. Public Health Service, Washington, DC 20005, USA.
Am J Prev Med. 2007 Jul;33(1):9-14. doi: 10.1016/j.amepre.2007.02.044.
People detained by United States Immigration and Customs Enforcement (ICE) are a high-risk population for tuberculosis (TB). Detainees are screened for TB upon intake, and TB patients are reported to the Division of Immigration Health Services (DIHS).
TB case reports were reviewed for ICE detainees reported to DIHS during 2004-2005. Case counts and frequency distributions are presented. Case counts are stratified by demographic characteristics, release status, laboratory and clinical findings, HIV/AIDS status, and drug resistance. Case rates were calculated for patients housed at facilities with DIHS staffing. Duration of treatment and of ICE custody is provided. Analyses were conducted in 2006.
During 2004 and 2005, 76 and 142 TB patients were reported, respectively. The TB case rate was 82.6/100,000 in 2004 and 121.5/100,000 in 2005. The culture-confirmed case rate of 55.8/100,000 in 2005 was 2.5 times higher than the case rate in the U.S. foreign-born population. Of 218 patients, 127 (58.3%) had Mycobacterium tuberculosis-positive sputum cultures, 70 (32.1%) had acid-fast bacilli-positive sputum smears, and 36 (16.5%) were symptomatic at diagnosis. Patients from Mexico, Honduras, Guatemala, and El Salvador accounted for 184 cases (84.4%) and 184 patients (84.4%) were repatriated. TB patients spent an average 82.6 days in treatment before release or repatriation.
Screening at intake to ICE custody has helped DIHS staff in diagnosing TB and starting patients on treatment, but patients are usually deported before completing therapy. Because of deportation, and sometimes re-entry into the United States, unique collaborations are required to support completion of treatment.
被美国移民和海关执法局（ICE）拘留的人员是结核病（TB）的高危人群。被拘留者在入境时会接受结核病筛查，结核病患者会被报告给移民健康服务司（DIHS）。
对2004 - 2005年期间报告给DIHS的ICE被拘留者的结核病病例报告进行了审查。列出了病例数和频率分布。病例数按人口统计学特征、释放状态、实验室和临床检查结果、艾滋病毒/艾滋病状态以及耐药性进行分层。计算了配备DIHS工作人员的设施中患者的发病率。提供了治疗时间和ICE拘留时间。分析于2006年进行。
2004年和2005年分别报告了76例和142例结核病患者。2004年结核病发病率为82.6/10万，2005年为121.5/10万。2005年经培养确诊的发病率为55.8/10万，是美国外国出生人口发病率的2.5倍。在218名患者中，127名（58.3%）痰培养结核分枝杆菌呈阳性，70名（32.1%）痰涂片抗酸杆菌呈阳性，36名（16.5%）在诊断时有症状。来自墨西哥、洪都拉斯、危地马拉和萨尔瓦多的患者占184例（84.4%），184名患者（84.4%）被遣返。结核病患者在获释或被遣返前平均接受82.6天的治疗。
对进入ICE拘留所的人员进行筛查有助于DIHS工作人员诊断结核病并开始对患者进行治疗，但患者通常在完成治疗前被驱逐出境。由于被驱逐出境，有时还会再次进入美国，因此需要独特的合作来支持完成治疗。
