Faculty mentor/PI email address
klee@rowan.edu, schachter@rowan.edu
Keywords
tuberculosis, Asian American, population health, immigrant health
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Tuberculosis in Long-Term Asian American Immigrant Residents: Trends and Risk Factors in Cases Diagnosed ≥10 Years After U.S. Arrival
Katherine Xie, MSc1, Kai Mon Lee, PhD1, Todd Schachter, DO1
1Rowan-Virtua School of Osteopathic Medicine, 1 Medical Center Dr, Stratford, NJ 08084
Background
In the U.S., TB cases are largely due to reactivation of latent TB infections (LTBI) of immigrants from high-burden countries. The CDC and U.S. Preventive Services Task Force currently recommend screening newer immigrant populations, especially those born in highly-burdened areas with TB. This guideline mostly targets newly immigrated populations, defined as those who have arrived less than 5 years ago. There are few studies looking into how TB impacts Asian American populations. A study analyzing 2010-2015 TB data found an increase in the number and proportion of non-U.S. origin born patients being diagnosed with TB, despite their arrivals being more than 10 years ago (Tsang, 2017). This study furthers the work examining trends in TB diagnoses specifically amongst Asian American immigrants and the risk factors that may contribute to reactivation or new infections.
Methods
Secondary analysis of CDC’s National TB Surveillance System (NTSS) reporting all TB cases from 2013-2023 extracted through the CDC WONDER TB OTIS Database, which hosts and sorts the NTSS data. Data was grouped by “Years in U.S.” and data extraction was restricted to “non-U.S. born” and “Asian or Pacific Islander, Non-Hispanic” to identify Asian American immigrant TB cases only. Cases with unknown time since arrival were excluded from analysis. Data was analyzed through RStudio. Chi-squared tests were used to analyze significance of trends and associations.
Results
Data analysis suggests an increase over time (2013-2023) of long-term residents being more and more likely to be diagnosed with TB than newer immigrants who have been in the U.S. for less than 10 years. An increase in age was correlated with greater TB cases in residents of more than 10 years in the U.S. (p < 0.05). Alcohol use was found in 2.8% of those with less than 10 years of residence, and 3.8% in those with 10 years or more of residence. Individuals with ≥10 years of residence had a greater proportion of former smokers diagnosed with TB (24.1%) than those who were former smokers and have been here less than 10 years (14.1%) (p < 0.05). Those diagnosed with TB and who have been in the U.S. for more than 10 years were also 4 times more likely to have been in long-term care facilities (p < 0.05).
Conclusion
Trending increase of TB cases in Asian American residents of ≥ 10 years, suggest reactivation of latent cases. Tuberculosis occurrence, whether from latent reactivation or from new infection, is significantly higher in Asian American immigrants (non-U.S origin) who have been residents in the U.S. for at least 10 years or more. Data suggests that this trend has been increasing over 2013-2023, consistent with findings from 2010-2015. Screening protocols for TB for Asian American populations should also focus on long-term residents, rather than only focusing on recently immigrated populations.
Disciplines
Bacterial Infections and Mycoses | Epidemiology | Medicine and Health Sciences | Population Health
Included in
Bacterial Infections and Mycoses Commons, Epidemiology Commons, Population Health Commons
Tuberculosis in Long-Term Asian American Immigrant Residents: Trends and Risk Factors in Cases Diagnosed ≥10 Years After U.S. Arrival
Tuberculosis in Long-Term Asian American Immigrant Residents: Trends and Risk Factors in Cases Diagnosed ≥10 Years After U.S. Arrival
Katherine Xie, MSc1, Kai Mon Lee, PhD1, Todd Schachter, DO1
1Rowan-Virtua School of Osteopathic Medicine, 1 Medical Center Dr, Stratford, NJ 08084
Background
In the U.S., TB cases are largely due to reactivation of latent TB infections (LTBI) of immigrants from high-burden countries. The CDC and U.S. Preventive Services Task Force currently recommend screening newer immigrant populations, especially those born in highly-burdened areas with TB. This guideline mostly targets newly immigrated populations, defined as those who have arrived less than 5 years ago. There are few studies looking into how TB impacts Asian American populations. A study analyzing 2010-2015 TB data found an increase in the number and proportion of non-U.S. origin born patients being diagnosed with TB, despite their arrivals being more than 10 years ago (Tsang, 2017). This study furthers the work examining trends in TB diagnoses specifically amongst Asian American immigrants and the risk factors that may contribute to reactivation or new infections.
Methods
Secondary analysis of CDC’s National TB Surveillance System (NTSS) reporting all TB cases from 2013-2023 extracted through the CDC WONDER TB OTIS Database, which hosts and sorts the NTSS data. Data was grouped by “Years in U.S.” and data extraction was restricted to “non-U.S. born” and “Asian or Pacific Islander, Non-Hispanic” to identify Asian American immigrant TB cases only. Cases with unknown time since arrival were excluded from analysis. Data was analyzed through RStudio. Chi-squared tests were used to analyze significance of trends and associations.
Results
Data analysis suggests an increase over time (2013-2023) of long-term residents being more and more likely to be diagnosed with TB than newer immigrants who have been in the U.S. for less than 10 years. An increase in age was correlated with greater TB cases in residents of more than 10 years in the U.S. (p < 0.05). Alcohol use was found in 2.8% of those with less than 10 years of residence, and 3.8% in those with 10 years or more of residence. Individuals with ≥10 years of residence had a greater proportion of former smokers diagnosed with TB (24.1%) than those who were former smokers and have been here less than 10 years (14.1%) (p < 0.05). Those diagnosed with TB and who have been in the U.S. for more than 10 years were also 4 times more likely to have been in long-term care facilities (p < 0.05).
Conclusion
Trending increase of TB cases in Asian American residents of ≥ 10 years, suggest reactivation of latent cases. Tuberculosis occurrence, whether from latent reactivation or from new infection, is significantly higher in Asian American immigrants (non-U.S origin) who have been residents in the U.S. for at least 10 years or more. Data suggests that this trend has been increasing over 2013-2023, consistent with findings from 2010-2015. Screening protocols for TB for Asian American populations should also focus on long-term residents, rather than only focusing on recently immigrated populations.