TY - JOUR
T1 - Screening nonimmigrant visitors to the United States for tuberculosis
T2 - Report of the Council on Scientific Affairs
AU - Tan, L.
AU - Altman, R. D.
AU - Nielsen, N. H.
AU - Dickinson, B. D.
PY - 2001/2/12
Y1 - 2001/2/12
N2 - Objective: To assess the desirability of requiring proof of tuberculosis (TB) screening for nonimmigrant visitors to the United States. Data Sources: Literature review using the MEDLINE database for 1966 to 1999 and the Lexis-Nexis database for 1998 to 1999 on the terms tuberculosis and transmission, combined with the qualifiers foreign visitors, foreign students, foreign born, and policy. Experts in TB control from the Centers for Disease Control and Prevention, Atlanta, Ga, and the Canadian government were consulted. The World Wide Web was searched using the terms tuberculosis and transmission. Data Extraction: English-language articles with information directly related to control of TB transmission among foreign-born persons were selected. Results and Conclusions: Eliminating TB in the United States will depend significantly on the ability to control it within the foreign-born population; however, strict border screening guidelines used as exclusionary measures can actually worsen the epidemic. Overseas TB screening of nonimmigrant visitors, who are unlikely to have active TB and even less likely to transmit it, will be of extremely low yield, would significantly deviate from the US "open-door" policy for nonimmigrants, and would have great logistical and political implications. Foreign-born persons 15 years and older who intend to stay in the United States are the high-risk population most likely to affect public health and thus will provide the best yield for TB control resources. Screening and monitoring the nonimmigrant foreign-born population would divert valuable resources from now established, successful TB control programs for foreign-born immigrants.
AB - Objective: To assess the desirability of requiring proof of tuberculosis (TB) screening for nonimmigrant visitors to the United States. Data Sources: Literature review using the MEDLINE database for 1966 to 1999 and the Lexis-Nexis database for 1998 to 1999 on the terms tuberculosis and transmission, combined with the qualifiers foreign visitors, foreign students, foreign born, and policy. Experts in TB control from the Centers for Disease Control and Prevention, Atlanta, Ga, and the Canadian government were consulted. The World Wide Web was searched using the terms tuberculosis and transmission. Data Extraction: English-language articles with information directly related to control of TB transmission among foreign-born persons were selected. Results and Conclusions: Eliminating TB in the United States will depend significantly on the ability to control it within the foreign-born population; however, strict border screening guidelines used as exclusionary measures can actually worsen the epidemic. Overseas TB screening of nonimmigrant visitors, who are unlikely to have active TB and even less likely to transmit it, will be of extremely low yield, would significantly deviate from the US "open-door" policy for nonimmigrants, and would have great logistical and political implications. Foreign-born persons 15 years and older who intend to stay in the United States are the high-risk population most likely to affect public health and thus will provide the best yield for TB control resources. Screening and monitoring the nonimmigrant foreign-born population would divert valuable resources from now established, successful TB control programs for foreign-born immigrants.
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U2 - 10.1001/archinte.161.3.334
DO - 10.1001/archinte.161.3.334
M3 - Article
C2 - 11176758
AN - SCOPUS:0035847593
VL - 161
SP - 334
EP - 340
JO - JAMA Internal Medicine
JF - JAMA Internal Medicine
SN - 2168-6106
IS - 3
ER -