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        Appendix - Sample Epidemiologic Profile

        The following table (Table_A1) represents some elements of a tuberculosis (TB) profile for a foreign-born person that should be considered for use in state and local health departments.
        Table_A1
        Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.

        
        SAMPLE EPIDEMIOLOGIC PROFILE
        ===============================================================================================
        Data                          Sources                        How data will be used
        -----------------------------------------------------------------------------------------------
        Demographics
        Patient's age at diagnosis    "Reports of Verified Cases     Targeting of programmatic
                                      of Tuberculosis"               efforts
        Patient's age at entry to
        United States
        Country of origin
        Sex
        Employed (Y/ N)
        Years in United States at     "Reports of Verified Cases     Identification of at- risk
        time of diagnosis             of Tuberculosis"               groups; identification of
                                                                     missed opportunities for
                                                                     prevention
        
        Source case identified        Add to "Reports of Verified    Transmission in foreign-born
        (especially in pediatric      Cases of Tuberculosis"         community; strategy for case
        cases)                                                       finding
        
        Clinical/ diagnostic          Add to "Reports of Verified    Program management;
        - Previous treatment for TB   Cases of Tuberculosis"         issues surrounding delays in
        (Past preventive treatment?)                                 diagnosis; issues regarding
        - Acid- fast bacilli smear                                   treatment; issues regarding
        - Acid- fast bacilli culture                                 preventive therapy;
        - Drug susceptibility                                        advocacy; program planning
        - HIV status
        
        Case Management
        Type of provider              "Reports of Verified Cases     Targeting provider education
                                      of Tuberculosis"
        
        Patient on directly observed  "Reports of Verified Cases     Patient management
        therapy?                      of Tuberculosis"
        
        Completion of therapy         Add to "Reports of Verified    Program management;
                                      Cases of Tuberculosis"         identifying high- risk
                                                                     patients;
                                                                     targeting programs.
        
        Drug regimen                  "Reports of Verified Cases     Program management
        Drug resistance               Tuberculosis" and WHO
        
        Case Finding
        Screening program             State and local health         Evaluation of program
        - Number screened             departments                    performance
        - Number infected
        - Cases found
        - Preventive treatment
          completed
        
        Contact tracing               CDC and state and local        Evaluation of program
        - Done or not?                health departments             performance
        - Number of contacts
          identified per case
        - Number of cases with no
          contacts identified
        - Number (%) infected with
          no disease
        - Number (%) placed on
          preventive therapy
        - Number (%) completed
          preventive therapy
        - Cases found
        
        Class B1/ B2 Cases
        Number of notifications       CDC/ National Center for       Resource allocation
                                      Infectious
                                      Diseases/ Division of
                                      Quarantine
        Number investigated           CDC/ National Center for       Resource allocation
                                      Infectious
                                      Diseases/ Division of
                                      Quarantine and state and
                                      local health departments
        Number eligible for           CDC/ National Center for       Prioritization of resources
        prevention
        Number with disease           Infectious
        Number started on treatment   Diseases/ Division of
        Number completed treatment    Quarantine and state and
                                      local health departments
        
        Civil Surgeon Referral
        Number with status            U. S. Department of            Assessment of potential
        readjusted                    Justice/ Immigration and       burden to health
                                      Naturalization Service         department
        Number eligible for           U. S. Department of            Resource allocation;
        prevention
        Number with disease           Justice/ Immigration and       advocacy for medical
        Number referred to health     Naturalization Service and     services
        department (asylees)          local health department
        
        Qualitative Data on
        Screening
        Special studies               Local health departments       Program planning/ resource
        - Schools/ universities                                      allocation; strategy for
                                                                     case finding
        - English- as- second-
          language schools
        - Community- based
          organizations
        
        Immigration Profile
        Current population profiles   U. S. Census Bureau and        Program planning;
        New immigration               U. S. Department of            resource allocation;
        - Overseas immigrants         Justice/ Immigration and       advocacy for medical
        - Adjustment of status        Naturalization Service         services
        - Asylum seekers
        
        Special Studies
        Barriers to accessing care    State and local health         Issues regarding access -
        - Language                    departments                    advocacy for medical
        - Financial                                                  services
        - Legal
        - Cultural
        - Knowledge
        - Health beliefs
        
        Patient versus provider       State and local health         Issues regarding early
        delays                        departments                    diagnosis; patient and
        - Duration of symptoms                                       provider education
          before diagnosis
        - Number of visits made
          before diagnosis
        - Type of provider
        
        ===============================================================================================
        

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