|
 |
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2005.067512
LETTER |
The author is a graduate student in the School of Nursing, University of North Carolina, Chapel Hill.
Correspondence: Requests for reprints should be sent to Hongling Xia, RN, 8001 Mackenzie Ct, Durham, NC 27713 (e-mail: hxia888{at}yahoo.com).
Thank you for publishing "Drive-by Readings: A Creative Strategy for Tuberculosis Control Among Immigrants" in the January 2005 issue.1 The authors of this article used an innovative strategy to identify foreign-born persons at risk for tuberculosis (TB). They held a clinic at an airport where New York City taxi drivers (most of whom were immigrants) waiting to pick up customers could be tested, and then they set up a drive-through clinic where the taxi drivers could simply stick out their arms and have health care workers read the skin reaction. Those who had positive reactions were advised on what to do next. I applaud the authors’ innovative efforts to increase TB screening in this high-risk group.
Even though TB rates have declined nationwide in recent years after a short-term spike between 1985 and1992, TB case rates have increased in certain states, and elevated TB rates continue to be reported in certain populations (e.g., foreign-born persons and racial/ethnic minorities).2 One Centers for Disease Control and Prevention report said that "the case rate among foreign-born persons remains at least seven times higher than among US-born persons."3 Identifying foreign-born populations with latent TB infection and administering preventive treatment to them before the disease actually strikes are 2 very important TB control measures. However, it is difficult for public health workers to reach these populations by means of traditional public health approaches. At the same time, language, cultural, and economic impediments hinder immigrants’ access to the health care system. As a result, a large number of people who should have been identified through TB screening and given preventive treatment are being missed.
As a public health nurse working at the TB control unit of a local health department in North Carolina, I saw the frustration of both public health workers and the foreign-born population. I am also an Asian immigrant. I think there is a great need for innovative approaches in TB control if we are serious about eliminating TB in the United States. Publishing articles about innovative approaches for identifying at-risk populations, improving adherence to preventive treatment, and other TB control measures in the Journal will help public health workers open discussions on this topic, share their successful experiences, and gain knowledge and support from each other. I look forward to future articles on this subject.
References
1. Gany FG, Trinh-Shevrin C, Changrani J. Drive-by readings: a creative strategy for tuberculosis control among immigrants. Am J Public Health. 2005; 95:117–120.
2. Centers for Disease Control and Prevention. Trends in tuberculosis—United States, 1998–2003 [published correction appears in MMWR Morb Mortal Wkly Rep. 2004;53(11);246]. MMWR Morb Mortal Wkly Rep. 2004;53(10):209–214.[Medline]
3. Centers for Disease Control and Prevention. Tuberculosis morbidity among U.S.-born and foreign-born populations—United States, 2000. MMWR Morb Mortal Wkly Rep. 2002;51(5);101–104.[Medline]
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |