Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Trop Med Hyg. 2024 Mar 26;110(5):999-1005. doi: 10.4269/ajtmh.23-0233. Print 2024 May 1.
Persons may seek asylum in the United States or at a U.S. port of entry. Principal asylees are those who are granted asylum status. Their spouse and unmarried children under 21 years of age may be granted asylum if accompanying, or following to join, the principal asylees. U.S.-bound follow-to-join asylees must undergo an overseas medical examination that includes tuberculosis (TB) screening. Culture-based overseas TB screening in U.S.-bound follow-to-join asylees has not been evaluated. We evaluated data from overseas TB screening in 19,088 arrivals of follow-to-join asylees during 2014-2019 and assessed data from their postarrival evaluation, which is recommended for those at risk for TB. Of 19,088 arrivals of follow-to-join asylees, 29 (152 cases/100,000 persons) met criteria for class B0 TB (recent completion of TB treatment overseas) and 340 (1,781 cases/100,000 persons) met criteria for class B1 pulmonary TB (chest radiograph/clinical symptoms suggestive of TB but negative sputum cultures overseas). Of 6,847 persons aged 2 to 14 years from countries with a WHO-estimated TB incidence of ≥20 cases/100,000 population/year, 408 (6.0%) were classified as class B2 latent TB infection (LTBI). Postarrival evaluations were completed in 44.8%, 51.5%, and 40.4% of persons with class B0 TB, class B1 TB, and class B2 LTBI, respectively. In conclusion, culture-based overseas TB screening in U.S.-bound follow-to-join asylees is effective in identifying those with TB (class B0 TB) or those at risk for TB (class B1 TB and class B2 LTBI). Completion of postarrival evaluation for newly arrived follow-to-join asylees was less frequent than that reported for immigrants and refugees.
个人可以在美国或美国入境口岸寻求庇护。主要庇护申请人是那些获得庇护身份的人。如果随行或随后加入主要庇护申请人，其配偶和 21 岁以下未婚子女也可获得庇护身份。前往美国的随行庇护申请人必须接受海外体检，包括结核病（TB）筛查。针对前往美国的随行庇护申请人的基于培养的海外 TB 筛查尚未得到评估。我们评估了 2014 年至 2019 年期间 19088 名随行庇护申请人海外 TB 筛查的数据，并评估了他们入境后评估的数据，建议对有结核病风险的人进行评估。在 19088 名随行庇护申请人中，有 29 人（152 例/10 万人）符合 B0 类 TB（近期在海外完成结核病治疗）标准，340 人（1781 例/10 万人）符合 B1 类肺结核（胸片/有结核病临床症状但海外痰培养阴性）标准。在来自世界卫生组织估计结核病发病率≥20 例/10 万人/年的国家的 6847 名 2 至 14 岁的人中，有 408 人（6.0%）被归类为 B2 潜伏性结核感染（LTBI）。B0 类 TB、B1 类 TB 和 B2 类 LTBI 患者的入境后评估完成率分别为 44.8%、51.5%和 40.4%。总之，针对前往美国的随行庇护申请人的基于培养的海外 TB 筛查可以有效识别患有结核病（B0 类 TB）或有结核病风险（B1 类 TB 和 B2 类 LTBI）的人。新抵达的随行庇护申请人完成入境后评估的比例低于移民和难民。
