Powell K E, Brown E D, Farer L S
JAMA. 1983 Mar 18;249(11):1455-60.
Surveys of state tuberculosis control programs revealed that of the 262,602 Indochinese refugees who entered the United States in 1979 and 1980, approximately 1.5% either had tuberculosis at the time of entry or developed it by the end of 1980; another 18% were placed on preventive therapy. The refugees comprised 5.3% of the nationally counted cases during the two-year period. Age- and sex-specific incidence rates among Indochinese refugees were 30 to 200 times higher than those for other persons in the United States. For refugees who arrived in 1979, the incidence of tuberculosis during 1980 (231 per 100,000) was only one third the incidence during 1979 (719 per 100,000). For refugees who entered the United States in 1980, the incidence during 1980 was 480 per 100,000. Bacteriologic confirmation of the diagnosis was reported for only 26% of refugees, compared with 79% of other patients with tuberculosis in the United States, suggesting overdiagnosis of tuberculosis among refugees. However, age-specific rates of bacteriologically positive tuberculosis were still 14 to 70 times higher for refugees than for the United States as a whole.
对各州结核病控制项目的调查显示,在1979年和1980年进入美国的262,602名印度支那难民中,约1.5%在入境时患有结核病或在1980年底前患上结核病;另有18%接受了预防性治疗。在这两年期间,这些难民占全国统计病例的5.3%。印度支那难民中按年龄和性别划分的发病率比美国其他人群高30至200倍。对于1979年抵达的难民,1980年结核病发病率(每10万人中231例)仅为1979年发病率(每10万人中719例)的三分之一。对于1980年进入美国的难民,1980年发病率为每10万人中480例。据报告,只有26%的难民经细菌学确诊,而在美国其他结核病患者中这一比例为79%,这表明难民中结核病存在过度诊断的情况。然而,难民中按年龄划分的细菌学阳性结核病发病率仍比美国总体水平高14至70倍。