Newer tests detecting more TB of immigrants, refugees

ATLANTA, March 20 (UPI) —

The U.S. government saved $15 million by using more sensitive tuberculosis tests so immigrants and refugees are treated before arriving, officials say.

"This program has been one of the largest and most successful interventions in U.S. TB control during the past decade," Dr. Martin Cetron, director of the Centers or Disease Control and Prevention’s Division of Global Migration and Quarantine, said in a statement.

"In addition to creating major savings in healthcare costs, the program ensures immigrants and refugees get prompt care and correct treatment, which is vital to their health, the health of their loved ones, and the U.S. communities where they settle."

The $15 million cost savings estimate is a rough estimate based on the cost of treating TB cases that would not have otherwise been identified and treated prior to the immigrants’ and refugees’ arrival in the United States. Those costs are primarily borne by U.S. public health departments, both federal and state, that provide care and treatment for TB patients diagnosed after their arrival to the United States.

In 2012, the most recent year for which data are available, overseas physicians identified more than 1,100 cases of TB, including 14 cases of multidrug-resistant TB, a report by the CDC said. Newer, more sensitive sputum-culture TB tests identified about 60 percent of these cases.

More than a third of the world’s population is thought to be infected with Mycobacterium tuberculosis, the bacterium that causes TB. In 2012, nearly 9 million people around the world became sick with TB. Since the early 1900s, immigrants and refugees applying for a U.S. visa undergo a medical examination that includes TB screening.

Prior to 2007, applicants received a chest X-ray and microscopic sputum smear test to identify persons with active TB. Those who had a positive smear test received TB treatment prior to arriving in the United States.

However, these tests often missed persons with mild cases of TB.

In 2007, CDC began implementing new requirements that require people suspected of having tuberculosis to receive a much more sensitive sputum culture test to confirm TB so patients receive treatment prior to arriving in the United States. These requirements now apply to all countries with U.S.-bound immigrants.

The report is published in the CDC’s Morbidity and Mortality Weekly Report.