Immigrants suffer TB surge
By: Olivia Bowler, Assistant State & National Editor
Posted: 8/19/08
Tuberculosis cases are growing in prevalence in North Carolina and the disease is showing up disproportionately often among the state's immigrant population.

"We had 54 cases of TB in 2007. Sixty-five percent of those were foreign-born," said Gibbie Harris, Wake County community health director.

There were 52 cases in Wake County in 2006 and 34 in 2005.

TB cases are decreasing overall, said Maureen O'Rourke, TB program manager at the N.C. Department of Health and Human Services.

She said cases among immigrants are showing up in such high percentages because prevalence of the disease among the general population is declining.

TB treatment requires that a health care professional be present to monitor the patient when they take their medicine, said Carol Hamilton, medical director for the Health and Human Services TB Control Program.

"The treatment has been the same for 20 or 30 years, requiring anywhere from two to four different medications that are taken over six to nine months," she said.

That means that a TB patient is required to keep coming in to take multiple medicines, and that he must continue treatment even when he begins to feel better.

A new crop of obstacles arises when dealing with the immigrant community - difficulties on top of the ones already associated with treating TB.

The language barrier can complicate treatment, particularly for TB, which requires significant communication between the patient and the health care professional to follow the treatment schedule.

Hamilton said that because the Center for Disease Control and Prevention doesn't provide enough money to support full-time translators, some community health departments must dip into their own funds. Some counties cannot afford to hire a translator.

The uncertain nature of many immigrants' legal status can lead to reluctance to obtain adequate treatment.

"People distrust the medical profession in their new country, and many times people don't have insurance," Hamilton said.

Some patients' fears of deportation present obstacles for health care professionals, Hamilton said.

"If they're here illegally, at the public health clinics we've had a long-standing practice of just not asking," Hamilton said. "They don't always know that or trust that."

Harris said that individuals can carry tuberculosis for a long time before the disease actually becomes active, so the cases may originate in immigrants' home countries.

"They've been exposed back in their country," she said. "But most people never get sick with it."



Contact the State & National Editor at stntdesk@unc.edu.
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