Foreign-born adolescents were more likely to complete tuberculosis care than non-foreign born adolescents, according to a policy brief released by the UCLA Chicano Studies Research Center.

The findings suggest that culture, ethnicity and youth should not be looked upon as impediments but as potential resources, according to the study's authors, Donald E. Morisky, professor and chair of the UCLA department of community health sciences, and UCLA students Astou Coly and Michael Kim.

"These findings challenge the usual view of immigrant populations, suggesting the need for additional research that not only addresses this high-risk group but also learns valuable lessons from them about health-promoting behavior that can benefit everyone," said Chon Noriega, director of the center.

For the study, a total of 766 low-income adolescents between the ages of 11 and 19, including 610 foreign-born adolescents, were recruited from two public health clinics in Los Angeles County.

Foreign-born adolescent participants had higher medication-taking behavior scores and were better about keeping their appointments than United States-born participants. At the same time, however, the foreign-born population faces the highest risk for latent tuberculosis infection, which means they may develop the disease if they are not treated.

The study found that younger Latino or Asian adolescents from nonacculturated, two-parent families who were given an opportunity to understand their treatment in a caring environment were more likely to complete their care and decrease their risk of TB. Even though these adolescents were at the highest risk, their completion rates were higher than all other groups, including native-born adolescents.

According to the study, the culture of the foreign-born traditionally has been cited as a potential barrier to patient adherence. The study's findings, however, refute that position, showing that culture actually may have enhanced completion of care in the study's population. In fact, the more Americanized a foreign-born adolescent became, the less likely he or she was to complete treatment.


The findings present supportive evidence that tailored intervention programs should be developed to provide for the screening of and completion of treatment by foreign-born persons. The study suggests schools should continue screening children for TB and that intervention programs be tailored to reach foreign-born communities, among other recommendations.

Although the number of TB cases has been steadily decreasing in the U.S. general population, the spread of the disease has increased dramatically among foreign-born residents, according to the study. The proportion of foreign-born TB cases in the United States nearly doubled between 1990 and 1999, from 24 percent to 43 percent of all reported U.S. cases.

The rise of TB cases among foreign-born persons partly is due to the rise in immigrants to the United States, especially those from Asian and Latin American countries where TB rates are up to 20 times greater than those of the United States, the study stated. Of the foreign-born TB cases, 44 percent were Asian or Pacific Islanders and 36 percent were Latino or Hispanics. Mexico alone accounted for 23 percent of all foreign-born TB cases.

The report, "Successful Tuberculosis Prevention in Foreign-Born Adolescents," can be viewed at http://www.chicano.ucla.edu/press/briefs/current.html.