The number of cases of active TB among African immigrants has increased from fewer than 10 cases per year in the early 1990s to 24 cases in 2000. Three originated from Zambia and one each from Liberia and Egypt. Tuberculosis among the African immigrant cases tended to develop earlier after arrival in the U.S.A. when compared with other immigrants. The clinical presentation of TB also differed for African immigrant cases. Pott's Disease can be difficult to diagnose, and can cause vertebral collapse and severe neurological deficits.
Medical management is lengthy and frequently includes surgery.
One bit of good news is that drug resistance has not been a serious problem among the African immigrant TB cases. The number of refugees from countries in sub-Saharan Africa resettling into the United States has increased over the last 3 years. Many serious deficiencies were identified including the use of substandard techniques for TB screening. Additionally, DQ received reports from several state health departments that refugees have entered the U.S.A. with medical conditions such as infectious TB that had not been recognized and documented in the overseas medical screening process. Health care providers should be aware of the increase in TB among African immigrants, especially in the first years after arrival, and that the TB may present with unusual clinical manifestations.