Demographic and Clinical Characteristics, Care-Seeking Behavior, and Access to Health Care Among 149 Children <5 Years Old Newly Diagnosed With TB in the United States in 2005–2006 and Enrolled in Observational Study, by the Child’s Nativity

Participant CharacteristicsAll Cases (N = 149)US Born (N = 122)Foreign Born (N = 27)Risk Ratioa95% CI
n% (n/N)n% (n/N)n% (n/N)
 Younger than 1 y38263630274.281.06–17.22
 Between 1 and 4 y1117486702593referent
Country or world region of parent’s birthb
 Latin America/South America/Caribbean291925204151.390.52–3.71
 South Asia/East Asia/Pacific191315124150.840.33–2.17
 Sub-Saharan Africa1491084150.600.24–1.48
 United Statesc6400622excluded
Parent’s visa status at US entryd
Informant speaks English “not at all”
Parent feared child’s deportatione
 Not applicable2114211700excluded
 No opinion646500excluded
Health insurance
Reason for initially seeking health caref
 Screenings and well-baby examinations3725171420740.120.05–0.25
 Contact investigation or known TB exposure51344940276.511.60–26.38
Source case identified
Probable location of TB transmission
 Inside United States1026897805199.553.85–23.66
 Outside United States3624151221780.090.04–0.21
 Exposure risks both inside and outside United States117108142.070.31–13.86
TB site
 Pulmonary only10268836819700.910.43–1.94
 Pulmonary and extrapulmonary211417144150.940.36–2.45
 Extrapulmonary only261722184151.220.46–3.22
Abnormal chest radiograph
 Unknown/not done212200excluded
Specimen positive by culture
 Culture negative3826252013480.370.19–0.71
 Not done or unknown6644534313480.810.41–1.60
Tuberculin skin test positive at diagnosis
 Unknown/not done969700excluded
TB symptoms
  • a Risk ratio estimates the relative risk of US-born children compared with foreign-born children (with asymptotic 95% CIs).

  • b At least 1 parent born in given region. When discordant and US-born for 1 parent, foreign region given (n = 22); Mexico given when Mexican and Latin American parents (n = 4).

  • c All children were adopted (adoptee birth countries were Guatemala, China, Ethiopia, Kazakhstan, and 2 from the Russian Federation).

  • d At least 1 parent with given visa status. When discordant, undocumented given over documented.

  • e Interview informant was asked: “When you took your child for tuberculosis treatment, were you afraid you or your child might be sent back to the country you came from?”

  • f Reasons for initially seeking health care among adopted children were post adoption check-ups (n = 4), well-baby examinations, and symptoms (n = 1).