RESUMO
RATIONALE AND OBJECTIVES: Identifying and treating persons with latent tuberculosis (TB) infection (LTBI) at high risk for developing TB is part of the current TB elimination strategy. There are no specific criteria, other than medical risks, to designate groups as high risk for developing TB. We hypothesized that, if location-based screenings were done in communities where persons with genotypically clustered Mycobacterium tuberculosis resided, then persons with LTBI from recent transmission and with undiagnosed TB could be identified. METHODS: Location-based TB screenings were done in partnership with multiple community-based organizations using resources previously used for other types of screening. MAIN RESULTS: Location-based screenings identified one person with TB for every 83 screened, and one person with LTBI for every five screened. The yield of this targeted screening program for discovering persons with TB and LTBI exceeded what would be expected from nontargeted screening in a county with a TB incidence of 5.7 per 100,000 population. CONCLUSIONS: Genotyping combined with geographic information systems analysis can potentially be used to define high-risk status and to define areas for location-based TB screenings.
Assuntos
Portador Sadio/diagnóstico , Sistemas de Informação Geográfica , Programas de Rastreamento/métodos , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Pulmonar/diagnóstico , Adolescente , Adulto , Idoso , Portador Sadio/epidemiologia , Análise por Conglomerados , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Texas , Teste Tuberculínico , Tuberculose Pulmonar/epidemiologiaRESUMO
This study was conducted to provide an assessment of the health status and health care utilization of children from former Yugoslavia living in Tarrant County. In addition, an assessment of barriers and problems encountered by these families in obtaining health care for their children was presented. One hundred thirteen households of refugee families arriving in Tarrant County from 1998 through 2000 participated by answering a 79-item health information questionnaire. The results revealed that most of the refugee families had no regular health care provider to assure continuity of medical care. Lack of access to dental care and inappropriate utilization of hospital emergency facilities were also identified as problems. Insufficient understanding of health insurance issues and inability to access health information were additional problems. Local and state health care agencies may help to improve health care delivery for these and future refugee children by addressing these problem areas.
Assuntos
Nível de Saúde , Refugiados , Adolescente , Criança , Pré-Escolar , Feminino , Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Masculino , Texas , Iugoslávia/etnologiaRESUMO
Incidence rates of sexually transmitted diseases in Tarrant County, Texas, from 1998 through 2000 were assessed and compared with the rates in Texas and the United States, with the focus on similarities and differences in gender, age, and race/ethnicity. Data were obtained from the Tarrant County Public Health Department, the Texas Department of Health, and the Centers for Disease Control and Prevention. The rates for gonorrhea and syphilis in Tarrant County were significantly higher than rates in Texas and the United States. The largest disparity was found among blacks, followed by Hispanics and then whites, with those aged 15 to 24 years at greatest risk. To increase awareness and reduce the burden of sexually transmitted diseases, prevention programs need to be developed.