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Prevalence of Tuberculosis Disease Among Adult US-Bound Refugees with Chronic Kidney Disease.

Bardenheier BH, Pavkov ME, Winston CA, Klosovsky A, Yen C, Benoit S, Gravenstein S, Posey DL, Phares CR. Prevalence of Tuberculosis Disease Among Adult US-Bound Refugees with Chronic Kidney Disease. Journal of immigrant and minority health. 2019 Dec 1; 21(6):1275-1281.

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Abstract:

The association between chronic kidney disease (CKD) and tuberculosis disease (TB) has been recognized for decades. Recently CKD prevalence is increasing in low- to middle-income countries with high TB burden. Using data from the required overseas medical exam and the recommended US follow-up exam for 444,356 US-bound refugees aged? = 18 during 2009-2017, we ran Poisson regression to assess the prevalence of TB among refugees with and without CKD, controlling for sex, age, diabetes, tobacco use, body mass index ( kg/m), prior residence in camp or non-camp setting, and region of birth country. Of the 1117 (0.3%) with CKD, 21 (1.9%) had TB disease; of the 443,239 who did not have CKD, 3380 (0.8%) had TB. In adjusted analyses, TB was significantly higher among those with than without CKD (prevalence ratio 1.93, 95% CI: 1.26, 2.98, p? < 0.01). Healthcare providers attending to refugees need to be aware of this association.




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