JAMA : the journal of the American Medical Association
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Although tuberculosis (TB) has been recognized as a significant health problem of migrant farm workers, the nature and extent of the problem have been poorly defined. We report the first population-based study of TB in a random sample of farm workers (n = 543) and the first use of recall antigens in an epidemiologic study of TB. Purified protein derivative positivity ranged from 33% in Hispanics to 54% in US-born blacks and 76% in Haitians. ⋯ The use of recall antigens made possible a better description of the epidemiology of TB by excluding false negatives and clarifying associations between infection and risk factors. We conclude that TB among farm workers represents a serious public health problem with previously unrecognized risk factors. Additional resources for migrant health care, improvements in health care access, and fundamental changes in the system of migrant labor are all necessary to reduce the transmission of TB.
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A national, population-based survey was initiated in 1988 to measure the prevalence of human immunodeficiency virus (HIV) infection in women giving birth to infants in the United States. Following standardized procedures, residual dried-blood specimens collected on filter paper for newborn metabolic screening were tested anonymously in state public health laboratories for maternal antibody to HIV. As of September 1990, annual survey data were available from 38 states and the District of Columbia. ⋯ Nationwide, an estimated 1.5 per 1000 women giving birth to infants in 1989 were infected with HIV. Assuming a perinatal transmission rate of 30%, we estimate that approximately 1800 newborns acquired HIV infection during one 12-month period. Preventing transmission of HIV infection to women and infants is an urgent public health priority.