Tuberculosis among foreign-born persons in Los Angeles County, 1992-1994

Objectives: To describe the epidemiology of foreign-born tuberculosis (TB) cases in Los Angeles County and to evaluate current TB screening and follow-up of immigrants and refugees (I&R) to the USA. Design: Retrospective analysis of the Los Angeles County TB registry between October 1992 and December 1994. We matched all cases who entered the USA during fiscal year 1993 (FY93) with a database from the tracking system of I&R with suspected TB. Results: Foreign-born persons accounted for 64% of all reported TB cases. Half were born in Mexico or Central America. Standardized incidence rates were 3–5 times higher than those of US-born persons for Mexicans and Central Americans, 6–7 times higher for North-east Asians, and 10–15 times higher for Southeast Asians. Among foreign-born cases who arrived during FY93, 5% of the Mexicans and Central Americans, 48% of the North-east Asians and 67% of the South-east Asians were registered by the tracking system. Conclusion: Mexicans and Central Americans accounted for the majority of cases but had a lower incidence of TB than Asians. The current screening procedures identify a large proportion of cases among recently arrived South-east Asians, but contribute little to the control of TB among Mexicans and Central Americans.