Drug-resistant tuberculosis in foreign-born persons from Mexico, the Philippines, and Vietnam - United States, 1993-1997

SETTING: Foreign-born persons in the United States represent a growing prop ortion of the nation's tuberculosis(TB)cases. OBJECTIVE: To characterize drug resistance patterns in foreign-born TB pati ents from the three most common birth countries. DESIGN: A descriptive analysis of national TB surveillance data for 1993-19 97. TB case reports for foreign-born persons who were at least 15 years old and born either in Mexico (6221), the Philippines (3624), or Vietnam (3351 ) were included. RESULTS: Among those with no prior history of TB, the proportions with ison iazid-resistant TB and MDR-TB (resistance to at least isoniazid and rifampi n) were 9.2% and 1.6% for persons from Mexico, 13.7% and 1.4% for those fro m the Philippines, and 17.8% and 1.4% for those from Vietnam. Levels of iso niazid resistance and MDR-TB did not change during the 5-year study period. Levels of isoniazid resistance decreased with older age for persons with n o prior TB from all three countries; however, rates of MDR-TB did not vary with age. Persons with <1 year of residence in the US were more likely to h ave MDR-TB; however, duration of residence in the US was not associated wit h isoniazid resistance. CONCLUSION: Increased drug resistance in younger and more recent arrivals s uggests that vigorous efforts to prevent further development of MDR-TB in t he three countries are essential.