Drug-resistant tuberculosis increasing among U.S. immigrant populations

Mar 23 2009

Although tuberculosis rates have declined in the U.S., drug-resistant strains of the disease are becoming increasingly prevalent in states with large immigrant populations, the AP/Google.com reports.

According to the AP/Google.com, the increase in drug-resistant TB comes as funding for TB programs in cities such as San Francisco, which has the highest TB rates nationwide, is being reduced, prompting concern among TB researchers.

Immigrants living in states such as California are particularly vulnerable to drug-resistant TB because many people frequently travel to countries with higher TB prevalence -- such as China, India or Mexico -- or were born in such countries. California recorded 2,696 TB cases in 2008 and 451 cases of drug-resistant TB between 1993 and 2007. About 83% of drug-resistant cases recorded in the state involved foreign-born immigrants, the AP/Google.com reports (Barbassa, AP/Google.com, 3/22). According to CDC, TB incidence in California was about seven cases per 100,000 people in 2008, compared with 4.2 cases per 100,000 people nationwide during the same year (Lin, Los Angeles Times, 3/22). In addition, a statewide analysis of drug-resistant TB cases between 1993 and 2006 found that the proportion of patients who could develop extensively drug-resistant TB increased from 7% to 33%. XDR-TB is resistant to two of the most potent first-line treatments and at least two of the classes of second-line drugs.

"California, having so much exposure to the world via immigration and travel, is particularly at risk," Gil Chavez, deputy director of the California Department of Public Health, said. Jennifer Grinsdale, program manager and epidemiologist with the TB control section of the San Francisco Department of Public Health, said recent budget cuts have hindered the city's ability to administer TB tests proactively to diagnose and treat latent TB cases in high-risk areas. "Anywhere from two to 10 years from now, we'll see the impact for this," Grinsdale said (AP/Google.com, 3/22).