Impact of immigration on the molecular epidemiology of tuberculosis in Rhode Island

Jessica Vanhomwegen, Awewura Kwara, Melissa Martin, Fizza S. Gillani, Arnaud Fontanet, Peninnah Mutungi, Joyce Crellin, Stephen Obaro, Michael Gosciminski, E. Jane Carter, Nalin Rastogi

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


While foreign-born persons constitute only 11% of the population in the state of Rhode Island, they account for more than 65% of incident tuberculosis (TB) annually. We investigated the molecular-epidemiological differences between foreign-born and U.S.-born TB patients to estimate the degree of recent transmission and identify predictors of clustering. A total of 288 isolates collected from culture-confirmed TB cases in Rhode Island between 1995 and 2004 were fingerprinted by spoligotyping and 12-locus mycobacterial interspersed repetitive units. Of the 288 fingerprinted isolates, 109 (37.8%) belonged to 36 genetic clusters. Our findings demonstrate that U.S.-born patients, Hispanics, Asian/Pacific islanders, and uninsured patients were significantly more likely to be clustered. Recent transmission among the foreign-born population was restricted and occurred mostly locally, within populations originating from the same region. Nevertheless, TB transmission between the foreign-born and U.S.-born population should not be neglected, since 80% of the mixed clusters of foreign- and U.S.-born persons arose from a foreign-born source case. We conclude that timely access to routine screening and treatment for latent TB infection for immigrants is vital for disease elimination in Rhode Island.

Original languageEnglish (US)
Pages (from-to)834-844
Number of pages11
JournalJournal of clinical microbiology
Issue number3
StatePublished - Mar 2011
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)


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