Including tuberculin skin test screening as part of a mobile medical clinic identified a number of patients with latent tuberculosis infection among foreign-born individuals with a high risk of infection, according to data from a recent study.
“Screening initiatives such as [this] provides an innovative strategy to improve TB detection and promote public health to reduce TB disease,” researchers from Yale University School of Medicine wrote in the American Journal of Public Health. “Such low threshold and grassroots programs are effective in detecting both newly and previously known latent TB infection, and findings here reflect high uptake utilization by not only underserved foreign-born populations but also by high-risk US-born populations.”
From January 2003 to June 2011, the Community Health Care Van, a mobile medical clinic that provides free care 5 days a week in impoverished areas of New Haven, Conn., had 8,322 unique clients for the latent TB infection screening program. Among those, 4,159 individuals (55.6%) were eligible for the tuberculin skin test. Among those, 1,699 individuals underwent screening and 1,325 returned for the skin test reading.
There were 339 positive test results. There were also 440 cases of latent TB infection diagnoses within the previous year among ineligible clients, for a total of 779 cases of latent TB infection and a prevalence of 16.9%. The prevalence of newly-diagnosed latent TB infection was 25.6%. Newly-diagnosed latent TB infection was significantly associated with being foreign-born (adjusted OR=8.49; 95% CI, 5.54-13.02).
Other independent predictors of newly-diagnosed latent TB infection included Hispanic and black races, being employed and increased age.
“Public health authorities should consider mobile medical clinics as an effective method to promote screening of at-risk, vulnerable populations for latent TB infection and thus provide innovative outreach that can further reduce TB disease among foreign-born and vulnerable populations,” the researchers wrote.