Last data update: Nov 04, 2024. (Total: 48056 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Brostrom RJ[original query] |
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TB-free Ebeye: Results from integrated TB and noncommunicable disease case finding in Ebeye, Marshall Islands
Brostrom RJ , Largen A , Nasa JN , Jeadrik G , Yamada S , Yadav S , Ko E , Warkentin JV , Chorba TL . J Clin Tuberc Other Mycobact Dis 2024 35 100418 BACKGROUND: Tuberculosis (TB) incidence rates in the Republic of the Marshall Islands are among the highest in the world, 480/100,000 in 2017. In response, the Health Ministry completed islandwide screening in Ebeye Island in 2017. METHODS: Participants were interviewed to obtain TB history, exposures, and symptoms. TB assessment included chest radiography with sputum collection for GeneXpert® MTB-RIF if indicated. TB diagnosis was made by consensus of visiting TB experts. Participants were also screened for Hansen's disease (HD) and diabetes mellitus (DM). For persons aged ≥21 years, blood pressure, cholesterol, and blood glucose were assessed. RESULTS: A total of 5,166 persons (90.0 % of target population) completed screening leading to the identification of 39 new cases of TB (755/100,000) and 14 persons with HD (270/100,000). DM was detected in 1,096 persons (27 %), including in 351 persons not previously diagnosed. The rate of hypertension was 61 % and of hypercholesterolemia was 15 %. New or prevalent TB diagnosis was associated with newly diagnosed or history of DM (aOR 4.68, 2.15-10.20). CONCLUSIONS: In Ebeye, an integrated TB screening campaign found TB, HD, DM, and hypertension. TB and DM were strongly associated. |
Outbreak of multidrug-resistant tuberculosis - Kansas, 2021-2022
Groenweghe E , Swensson L , Winans KD , Griffin P , Haddad MB , Brostrom RJ , Tuckey D , Lam CK , Armitige LY , Seaworth BJ , Corriveau EA . MMWR Morb Mortal Wkly Rep 2023 72 (35) 957-960 An outbreak of multidrug-resistant (MDR) tuberculosis (TB) involved 13 persons in four households in a low-income, under-resourced urban Kansas community during November 2021-November 2022. A majority of the seven adults identified in the Kansas outbreak were born outside the United States in a country that had experienced an MDR TB outbreak with the same genotype during 2007-2009, whereas most of the six children in the Kansas outbreak were U.S.-born. Prompt identification, evaluation, and treatment of persons with MDR TB and their contacts is essential to limiting transmission. |
Post-arrival evaluation of immigrant and refugee children in the USA with latent tuberculosis infection diagnosed overseas, 20072019
Wang Z , Posey DL , Brostrom RJ , Morris SB , Marano N , Phares CR . J Pediatr 2022 245 149-157 e1 OBJECTIVE: To assess outcomes from the U.S. post-arrival evaluation of newly arrived immigrant and refugee children aged 2-14 years who were diagnosed with latent tuberculosis infection (LTBI) during a required overseas medical examination. STUDY DESIGN: We compared overseas and U.S. interferon-γ release assay (IGRA)/tuberculin skin test (TST) results and LTBI diagnosis; assessed post-arrival LTBI treatment initiation and completion; and evaluated the impact of switching from TST to IGRA to detect Mycobacterium tuberculosis (Mtb) infection overseas. RESULTS: 73,014 children were diagnosed with LTBI overseas and arrived in the United States during 2007‒2019. In the United States, 45,939 (62.9%) completed, and 1,985 (2.7%) initiated but did not complete a post-arrival evaluation. Among these 47,924 children, 30,360 (63.4%) were retested for Mtb infection. For 17,996 children with a positive overseas TST, 73.8% were negative when retested by IGRA. For 1,051 children with a positive overseas IGRA, 58.0% were negative when retested by IGRA. Overall, among children who completed a post-arrival evaluation, 18,544 (40.4%) were evaluated as having no evidence of TB infection, and 25,919 (56.4%) had their overseas LTBI diagnosis confirmed. Among the latter, 17,229 (66.5%) initiated and 9,185 (35.4%) completed LTBI treatment. CONCLUSIONS: Requiring IGRA testing overseas could more effectively identify children who will benefit from LTBI treatment. However, IGRA reversions may occur, highlighting the need for individualized assessment for risk of infection, progression, and poor outcome when making diagnostic and treatment decisions. Strategies are needed to increase the proportions receiving a post-arrival evaluation and completing LTBI treatment. |
Notes from the Field: Meningeal and pulmonary tuberculosis on a commercial fishing vessel - Hawaii, 2017
Imada EK , Roberson EK , Goswami ND , Brostrom RJ , Moser K , Tardivel K . MMWR Morb Mortal Wkly Rep 2019 68 (24) 554-555 In December 2016, U.S. Customs and Border Protection notified the CDC Honolulu Quarantine Station of a crewman on a commercial fishing vessel who was hospitalized with suspected tuberculosis (TB); the crewman, in his mid-30s, was unconsciousness, intubated, and dependent upon mechanical ventilation to maintain his respiratory status. He was a native of a high TB-burden country (one with TB incidence exceeding 10 cases per 100,000 population per year)* in the Pacific region. Nine days earlier, he had been hospitalized in Hawaii following a 1-month history of headache, fever, night sweats, chills, fatigue, weight loss, breathing difficulties, and cough and recent onset of abdominal pain, vomiting, dizziness, and blurred vision. Brain computerized tomography (CT) and magnetic resonance imaging scans showed lesions in the left basal ganglia and left temporal lobe; chest CT showed multiple bilateral lung opacities with central cavitation. Pathology results from a lung biopsy demonstrated acid-fast bacilli with molecular and culture tests positive for Mycobacterium tuberculosis complex, susceptible to all first-line drugs. Cerebrospinal fluid demonstrated low glucose (23 mg/dL), elevated protein (247 mg/dL), and elevated white blood cell count (298 cells/uL) with a relative lymphocytic predominance (50%), consistent with TB meningitis. Testing for human immunodeficiency virus infection was negative, and the patient had no medical comorbidities. The Hawaii Department of Health (Hawaii DOH) was contacted to assist with the investigation. |
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