Pulmonary Tuberculosis Disease Among Immigrant Detainees: Rapid Disease Detection, High Prevalence of Asymptomatic Disease, and Implications for Tuberculosis Prevention

2020 ◽  
Author(s):  
Nicole J Boardman ◽  
Tiffany Moore ◽  
Jennifer Freiman ◽  
Geri Tagliaferri ◽  
Dakota McMurray ◽  
...  
Keyword(s):  
Chest Radiography ◽  
Disease Incidence ◽  
Diagnostic Testing ◽  
Acid Fast Bacillus ◽  
Rapid Screening ◽  
Symptom Screening ◽  
States Immigration ◽  
Immigration And Customs Enforcement ◽  
Immigrant Detention ◽  
Detention Facilities

Abstract Background Rapid screening for tuberculosis (TB) disease at intake into immigrant detention facilities allows for early detection and treatment. Detention facilities with United States Immigration and Customs Enforcement (ICE) Health Service Corps (IHSC) medical staffing utilize chest radiography and symptom screening as the primary screening for pulmonary TB (PTB) disease. This analysis describes the demographic, clinical, and microbiological characteristics of individuals identified with TB disease at these facilities. Methods We conducted a retrospective analysis to describe the population of immigrant detainees identified via chest radiography with PTB disease between 1 January 2014 and 31 December 2016 at facilities with IHSC medical staffing. We collected demographic variables, clinical presentation, diagnostic testing results, and microbiological findings. We generated descriptive statistics and examined univariate and multivariate associations between the variables collected and symptomatic status. Results We identified 327 patients with confirmed PTB disease (incidence rate, 92.8 per 100 000); the majority of patients were asymptomatic (79.2%) at diagnosis. Adjusting for all other variables in the model, the presence of cavitary lesions, acid-fast bacillus smear positivity, and multilobar presentation were significantly associated with symptomatic status. Among all patients identified with TB disease who had a tuberculin skin test (TST) result recorded, 27.2% were both asymptomatic and TST negative, including those with smear-positive disease. Conclusions Asymptomatic PTB disease is a significant clinical entity among immigrant detainees and placement in a congregate setting calls for aggressive screening to prevent transmission. Early identification, isolation, and treatment of TB disease benefit not only the health of the patient, but also the surrounding community.

scholarly journals COVID-19 Outbreaks in US Immigrant Detention Centers: The Urgent Need to Adopt CDC Guidelines for Prevention and Evaluation

2020 ◽  
Author(s):  
John J Openshaw ◽  
Mark A Travassos
Keyword(s):  
Federal Government ◽  
Homeland Security ◽  
Vulnerable Populations ◽  
Department Of Homeland Security ◽  
Detention Centers ◽  
Cdc Guidelines ◽  
Control And Prevention ◽  
Immigration And Customs Enforcement ◽  
Immigrant Detention ◽  
Detention Facilities

Abstract There have been several significant outbreaks of COVID-19 in federal immigrant detention centers, which lack clear and consistent guidelines across Department of Homeland Security (DHS) agencies to limit the spread of COVID-19. The Centers for Disease Control and Prevention (CDC) has issued detailed guidelines for the control, prevention, and evaluation of COVID-19 in detention facilities. Although the DHS’s Immigration and Customs Enforcement agency has stated that it complies with CDC recommendations, its policies significantly differ from these CDC guidelines, placing detainees at risk for contracting COVID-19. This submission urges the adoption of CDC guidelines across DHS-associated facilities. Such a policy change has the potential to protect and save the lives of the most vulnerable populations under the auspices of the federal government.

scholarly journals Outcomes of Community-Based Systematic Screening of Household Contacts of Patients with Multidrug-Resistant Tuberculosis in Myanmar

2019 ◽  
Vol 5 (1) ◽  
pp. 2
Author(s):  
Nang Thu Thu Kyaw ◽  
Aung Sithu ◽  
Srinath Satyanarayana ◽  
Ajay M. V. Kumar ◽  
Saw Thein ◽  
...  
Keyword(s):  
Chest Radiography ◽  
Multidrug Resistant ◽  
Sputum Smear ◽  
Community Based ◽  
Household Contacts ◽  
Resistant Tuberculosis ◽  
Symptom Screening ◽  
Multidrug Resistant Tuberculosis ◽  
Screening Algorithm ◽  
Mdr Tb

Screening of household contacts of patients with multidrug-resistant tuberculosis (MDR-TB) is a crucial active TB case-finding intervention. Before 2016, this intervention had not been implemented in Myanmar, a country with a high MDR-TB burden. In 2016, a community-based screening of household contacts of MDR-TB patients using a systematic TB-screening algorithm (symptom screening and chest radiography followed by sputum smear microscopy and Xpert-MTB/RIF assays) was implemented in 33 townships in Myanmar. We assessed the implementation of this intervention, how well the screening algorithm was followed, and the yield of active TB. Data collected between April 2016 and March 2017 were analyzed using logistic and log-binomial regression. Of 620 household contacts of 210 MDR-TB patients enrolled for screening, 620 (100%) underwent TB symptom screening and 505 (81%) underwent chest radiography. Of 240 (39%) symptomatic household contacts, 71 (30%) were not further screened according to the algorithm. Children aged <15 years were less likely to follow the algorithm. Twenty-four contacts were diagnosed with active TB, including two rifampicin- resistant cases (yield of active TB = 3.9%, 95% CI: 2.3%–6.5%). The highest yield was found among children aged <5 years (10.0%, 95% CI: 3.6%–24.7%). Household contact screening should be strengthened, continued, and scaled up for all MDR-TB patients in Myanmar.

scholarly journals Point-of-Care Testing-the Key in the Battle against SARS-CoV-2 Pandemic

Micromachines ◽  
2021 ◽  
Vol 12 (12) ◽  
pp. 1464
Author(s):  
Florina Silvia Iliescu ◽  
Ana Maria Ionescu ◽  
Larisa Gogianu ◽  
Monica Simion ◽  
Violeta Dediu ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Point Of Care ◽  
Low Cost ◽  
Diagnostic Testing ◽  
Clinical Decision ◽  
Rapid Screening ◽  
Diagnostic Tools ◽  
Point Of Care Testing ◽  
Qrt Pcr ◽  
User Friendly

The deleterious effects of the coronavirus disease 2019 (COVID-19) pandemic urged the development of diagnostic tools to manage the spread of disease. Currently, the “gold standard” involves the use of quantitative real-time polymerase chain reaction (qRT-PCR) for SARS-CoV-2 detection. Even though it is sensitive, specific and applicable for large batches of samples, qRT-PCR is labour-intensive, time-consuming, requires trained personnel and is not available in remote settings. This review summarizes and compares the available strategies for COVID-19: serological testing, Point-of-Care Testing, nanotechnology-based approaches and biosensors. Last but not least, we address the advantages and limitations of these methods as well as perspectives in COVID-19 diagnostics. The effort is constantly focused on understanding the quickly changing landscape of available diagnostic testing of COVID-19 at the clinical levels and introducing reliable and rapid screening point of care testing. The last approach is key to aid the clinical decision-making process for infection control, enhancing an appropriate treatment strategy and prompt isolation of asymptomatic/mild cases. As a viable alternative, Point-of-Care Testing (POCT) is typically low-cost and user-friendly, hence harbouring tremendous potential for rapid COVID-19 diagnosis.

scholarly journals Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention Facilities, 2011-2018

2021 ◽  
Vol 4 (7) ◽  
pp. e2116019
Author(s):  
Molly Grassini ◽  
Sophie Terp ◽  
Briah Fischer ◽  
Sameer Ahmed ◽  
Madeline Ross ◽  
...  
Keyword(s):  
Immigration And Customs Enforcement ◽  
Detention Facilities ◽  
Us Immigration

Undocumented Migrants and Detention Facilities

2014 ◽  
Author(s):  
Jelka Zorn
Keyword(s):  
Due Process ◽  
Political Community ◽  
Community Life ◽  
Undocumented Migrants ◽  
Ethical Considerations ◽  
Liberal Democracies ◽  
Immigrant Detention ◽  
The Right ◽  
Detention Facilities ◽  
Formal Status

Being undocumented does not mean being without ties to one’s host society: undocumented immigrants might work and have family and friends; they might be active in community life, etc. However, due to a lack of formal status, they are vulnerable to detention and deportation. Instead of vilifying migrants for their irregular situation, the article sees immigration controls as a source of unjust policies and practices. Immigrant detention means administrative imprisonment without the normal due process safeguards commonly demanded in liberal democracies. Its consequences are separated families and broken individuals. Social work is seen as a profession developing ethical considerations and arguments to advocate for the right to belong to an organized political community, the right to social security, and the right to personal liberties being applicable to all people, regardless of their immigration status.

scholarly journals Modeling COVID-19 and Its Impacts on U.S. Immigration and Customs Enforcement (ICE) Detention Facilities, 2020

2020 ◽  
Vol 97 (4) ◽  
pp. 439-447 ◽  
Author(s):  
Michael Irvine ◽  
Daniel Coombs ◽  
Julianne Skarha ◽  
Brandon del Pozo ◽  
Josiah Rich ◽  
...  
Keyword(s):  
Immigration And Customs Enforcement ◽  
Detention Facilities

scholarly journals Identification of Presymptomatic and Asymptomatic Cases Using Cohort-Based Testing Approaches at a Large Correctional Facility—Chicago, Illinois, USA, May 2020

2020 ◽  
Author(s):  
Ashutosh Wadhwa ◽  
Kiva A Fisher ◽  
Rachel Silver ◽  
Mitsuki Koh ◽  
Melissa M Arons ◽  
...  
Keyword(s):  
Correctional Facility ◽  
Cook County ◽  
County Jail ◽  
Time Points ◽  
Testing Strategies ◽  
Symptom Screening ◽  
Serial Testing ◽  
Group 2 ◽  
Detention Facilities ◽  
Testing Group

Abstract Background Coronavirus disease 2019 (COVID-19) continues to cause significant morbidity and mortality worldwide. Correctional and detention facilities are at high risk of experiencing outbreaks. We aimed to evaluate cohort-based testing among detained persons exposed to laboratory-confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in order to identify presymptomatic and asymptomatic cases. Methods During 1–19 May 2020, 2 testing strategies were implemented in 12 tiers or housing units of the Cook County Jail, Chicago, Illinois. Detained persons were approached to participate in serial testing (n = 137) and offered tests at 3 time points over 14 days (day 1, days 3–5, and days 13–14). The second group was offered a single test and interview at the end of a 14-day quarantine period (day 14 group) (n = 87). Results 224 detained persons were approached for participation and, of these, 194 (87%) participated in ≥1 interview and 172 (77%) had ≥1 test. Of the 172 tested, 19 were positive for SARS-CoV-2. In the serial testing group, 17 (89%) new cases were detected, 16 (84%) on day 1, 1 (5%) on days 3–5, and none on days 13–14; in the day 14 group, 2 (11%) cases were identified. More than half (12/19; 63%) of the newly identified cases were presymptomatic or asymptomatic. Conclusions Our findings highlight the utility of cohort-based testing promptly after initiating quarantine within a housing tier. Cohort-based testing efforts identified new SARS-CoV-2 asymptomatic and presymptomatic infections that may have been missed by symptom screening alone.

Private Prisons and the Shift in Marketplace From the War on Drugs to the War on Terror

2018 ◽  
pp. 86-101
Author(s):  
Karina Moreno
Keyword(s):  
United States ◽  
Public Support ◽  
War On Drugs ◽  
The United States ◽  
Private Prisons ◽  
Drug Law ◽  
Private Prison ◽  
States Immigration ◽  
Immigrant Detention ◽  
Prison Industry

This paper outlines the emergence of a new marketplace in the United States, immigration detention, especially after September 11th. This phenomenon is not limited to the United States, but is also observable in other countries as the result of the globalized economy. This paper first explains how the private prison industry adapted from shaping harsh drug law sentencing during the War on Drugs to now sponsoring legislative bills that target immigrants, the new “cash crop” for the private prison industry. Because of the securitization of immigration governance, politics of fear are easily used to justify and build public support for a tough stance on immigration. The end result is that immigrant detention is a highly lucrative and record-breaking profitable enterprise for private prison corporations, with little accountability in its treatment of immigrants and with more and more power in sponsoring and shaping legislation beneficial to their bottom line. Implications now that Trump, who ran a very xenophobic presidential campaign especially hostile to Mexicans and Muslims, are discussed.

Automated chest radiography and mass systematic screening for tuberculosis

2020 ◽  
Vol 24 (7) ◽  
pp. 665-673 ◽  
Author(s):  
F. Madhani ◽  
R. A. Maniar ◽  
A. Burfat ◽  
M. Ahmed ◽  
S. Farooq ◽  
...  
Keyword(s):  
Chest Radiography ◽  
Strong Association ◽  
Diagnostic Testing ◽  
X Rays ◽  
Computer Aided Detection ◽  
Data Collection Tool ◽  
Systematic Screening ◽  
X Ray ◽  
Detection Software ◽  
Using Data

BACKGROUND: Systematic screening for TB using automated chest radiography (ACR) with computer-aided detection software (CAD4TB) has been implemented at scale in Karachi, Pakistan. Despite evidence supporting the use of ACR as a pre-screen prior to Xpert® MTB/RIF diagnostic testing in presumptive TB patients, there has been no data published on its use in mass screening in real-world settings.METHOD: Screening was undertaken using mobile digital X-ray vehicles at hospital facilities and community camps. Chest X-rays were offered to individuals aged ≥15 years, regardless of symptoms. Those with a CAD4TB score of ≥70 were offered Xpert testing. The association between Xpert positivity and CAD4TB scores was examined using data collected between 1 January and 30 June 2018 using a custom-built data collection tool.RESULTS: Of the 127 062 individuals screened, 97.2% had a valid CAD4TB score; 11 184 (9.1%) individuals had a CAD4TB score ≥70. Prevalence of Xpert positivity rose from 0.7% in the <50 category to 23.5% in the >90 category. The strong linear association between CAD4TB score and Xpert positivity was found in both community and hospital settings.CONCLUSION: The strong association between CAD4TB scores and Xpert positivity provide evidence that an ACR-based pre-screening performs well when implemented at scale in a high-burden setting.

scholarly journals The Impact of COVID-19 on Immigration Detention

2021 ◽  
Vol 2 ◽  
Author(s):  
Fatma E. Marouf
Keyword(s):  
United States ◽  
Tracking System ◽  
The United States ◽  
Lessons Learned ◽  
Public Health Authority ◽  
Immigration Detention ◽  
Immigration And Customs Enforcement ◽  
The Impact ◽  
Detention Facilities ◽  
United States Code

COVID-19 has spread quickly through immigration detention facilities in the United States. As of December 2, 2020, there have been over 7,500 confirmed COVID-19 cases among detained noncitizens. This Article examines why COVID-19 spread rapidly in immigration detention facilities, how it has transformed detention and deportation proceedings, and what can be done to improve the situation for detained noncitizens. Part I identifies key factors that contributed to the rapid spread of COVID-19 in immigration detention. While these factors are not an exhaustive list, they highlight important weaknesses in the immigration detention system. Part II then examines how the pandemic changed the size of the population in detention, the length of detention, and the nature of removal proceedings. In Part III, the Article offers recommendations for mitigating the impact of COVID-19 on detained noncitizens. These recommendations include using more alternatives to detention, curtailing transfers between detention facilities, establishing a better tracking system for medically vulnerable detainees, prioritizing bond hearings and habeas petitions, and including immigration detainees among the groups to be offered COVID-19 vaccine in the initial phase of the vaccination program. The lessons learned from the spread of COVID-19 in immigration detention will hopefully lead to a better response to any future pandemics. In discussing these issues, the Article draws on national data from January 2019 through November 2020 published by Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP), two agencies within DHS. The main datasets used are detention statistics published by ICE for FY 2019 (Oct. 2018-Sep. 2019), FY 2020 (Oct. 2019-Sep. 2020), and the first two months of FY 2021 (Oct. 2020-Nov. 2020). These datasets include detention statistics about individuals arrested by ICE in the interior of the country, as well as by CBP at or near the border. Additionally, the Article draws on separate data published by CBP regarding the total number of apprehensions at the border based on its immigration authority under Title 8 of the United States Code, as well as the number of expulsions at the border based on its public health authority under Title 42 of the United States Code.

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