In Nassau County, New York, in the last decade, the percentage of patients with tuberculosis (TB) who were foreign born increased from 39 percent to 78 percent. To minimize the occurrence of tuberculosis, the Nassau County Department of Health (DOH) provides a program of targeted testing and case management for high-risk populations. Providing tuberculin skin testing (TST) to this group, identifying latent TB infection (LTBI), and treatment should lead to a decrease in the incidence of TB. Dedicated staff is able to monitor patients through completion of therapy, either with directly observed therapy (DOT) or weekly or biweekly home visits. The new immigrant population is reached at community-based organizations (CBOs), especially those that provide English as a Second Language (ESL) classes.

The goal of this program is to access individuals at high risk for developing TB disease and to provide therapy for LTBI in order to eliminate TB.

Since August of 2001, of 1,251 immigrants attending ESL classes, 48 percent (597) completed testing, and 39 percent (233) of those tested were positive and were referred for medical evaluation.