Tuberculosis and migrant farm workers

Article Abstract:

The Migrant Health Program has estimated that there are between three and five million migrant and seasonal farm workers in the United States. Between 1984 and 1985, the Center for Disease Control (CDC) conducted a survey of tuberculosis (TB) cases reported in 29 states, and showed that farm workers accounted for more than 5 percent of all TB cases. TB is an infectious disease caused by the bacteria Mycobacterium tuberculosis, and is characterized by inflammation, formation of node-like lesions, tissue death, formation of fiber-like tissue, and deposition of calcium. This disease primarily affects the respiratory system but can also involve other organ systems. A study by Ciesielski and colleagues in the April 3, 1991 issue of The Journal of the American Medical Association examined the prevalence of TB among migrant farm workers in North Carolina in 1988. Active disease was identified in 3.6 percent of American blacks and 0.5 percent of Hispanics, whereas TB infection was detected in 37 percent of Hispanics, 62 percent of American blacks, and 76 percent of Haitians. These results are consistent with previous studies showing a high prevalence of TB among migrant workers. In addition, 41 percent of migrant workers had served time in prison, 31 percent had been homeless, and many were recruited for employment from soup kitchens, alcohol treatment centers, and homeless shelters. The health care needs of migrant workers have not been appropriately addressed, and language, cultural, educational, and other problems interfere with the access to or acceptance of health services provided at health centers. Migrant workers with TB should be identified and appropriately treated, and all close contacts, such as family members, of the affected patients should also be assessed. Patients should be provided with their health records to help in the tracking of TB cases. Tuberculin screening and preventive treatment should also be provided to migrant workers. Improvements in methods of preventing and controlling TB, and concerted efforts of health professionals and public health departments, can help to eliminate TB from the migrant worker population. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, editorial

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The epidemiology of tuberculosis among North Carolina migrant farm workers

Article Abstract:

Tuberculosis (TB) is a disease caused by infection with the bacteria Mycobacterium tuberculosis. It is characterized by inflammation, formation of tubercles (node-like lesions), tissue death, formation of fiber-like tissue, and deposition of calcium. The disease commonly affects the respiratory system but may also involve other organ systems. The incidence of TB decreased until the mid-1980s, when the prevalence of TB increased again in association with human immunodeficiency virus (HIV) infection. TB occurs with increased frequency among minorities, the homeless, prisoners, alcoholics, and the poor. Farm workers often originate from Mexico, Central America, and Haiti, where TB occurs with much greater frequency than in the United States. The epidemiology of TB among farm workers must be assessed in order to decrease the overall incidence of this disease. In 1988, the epidemiology of TB among migrants was assessed in 543 farm workers in North Carolina. Immunological evidence of TB was obtained in 33 percent of Hispanics, 54 percent of blacks born in the United States, and 76 percent of Haitians. Active TB was identified in 3.6 percent of American blacks and 0.5 percent of Hispanics. These findings suggest that TB is a serious health problem among farm workers, and that it may be addressed by providing additional resources for migrant health care, improving their access to health care, and reducing the transmission of TB. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Global epidemiology of tuberculosis: morbidity and mortality of a worldwide epidemic

Article Abstract:

Tuberculosis occurs worldwide, although people in developing countries seem to have the highest rate of infection and tuberculosis-related death. In 1990, there were estimated to be more than 7.5 million cases of tuberculosis worldwide, 3.5 million of which had been reported to health authorities. Ninety-five percent of cases occurred in developing countries and most appeared in young or middle-aged people. Estimates suggest that 2.5 million people died of tuberculosis in 1990. HIV infection has increased the rate of tuberculosis worldwide, especially in sub-Saharan Africa. After years of declining tuberculosis rates in some industrialized countries, the number of cases increased in the mid-1980s through the early 1990s. The appearance of drug-resistant tuberculosis is complicating disease control efforts. The World Health Organization has established strategies for tuberculosis control that require cooperation at the national level for success.

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