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Francesca M. Gany, MD, MS, Chau Trinh-Shevrin, DrPH and Jyotsna Changrani, MD, MPH

Francesca M. Gany, Chau Trinh-Shevrin, and Jyotsna Changrani are with the Center for Immigrant Health at the New York University School of Medicine, New York, NY.

Correspondence: Requests for reprints should be sent to Francesca Gany, MD, MS, Center for Immigrant Health, New York University School of Medicine, BCD-D-401, 550 First Ave, New York, NY 10016 (e-mail: fg12{at}nyu.edu).

Objectives. We explored an innovative strategy for targeted testing and disease management among immigrant communities at risk for tuberculosis.

Methods. Taxi drivers were recruited at an airport holding lot to undergo tuberculin skin testing (Mantoux). After receiving their test results in a location convenient for them, drivers with positive results were referred for evaluation and treatment. We conducted baseline and follow-up assessments.

Results. Of 123 drivers who participated, two thirds (82) were at high risk for tuberculosis. Seventy-eight (63%) of the 123 returned for test readings; 62% of these drivers had positive test results. All drivers with positive results received a complete physician evaluation, but 64% of those evaluated were not treated for latent TB infection. Of the untreated drivers, 37.5% were at high risk. Systemic and physician barriers (e.g., lack of knowledge, erroneous beliefs regarding vaccines) affected adherence to evaluation and treatment.

Conclusions. Targeted testing and treatment are important to the control of tuberculosis. The results of this study highlight the need for an aggressive physician educational campaign to identify latent tuberculosis infection and to tailor service delivery to meet the unique needs of foreign-born communities.

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