NCPA - National Center for Policy Analysis


June 8, 2005

A multidrug-resistant tuberculosis known as MDR-TB is persistent in California, primarily among its foreign-born population, and has serious financial implications for the state's public-health system, say federal and state health officials.

Treatment for MDR-TB is very expensive -- ranging from $200,000 to $1.2 million per person, over an 18- to 24-month time period, says Dr. Reuben Granich, a lead investigator for the Centers for Disease Control and Prevention.

Granich's findings were published the Journal of the American Medical Association (JAMA) in an article cowritten with California health officials. They studied 38,291 reported tuberculosis cases in California from 1994 to 2003:

  • Of those, 407 were classified as drug-resistant and were found mostly in patients from Mexico or the Philippines.
  • Some 84 percent of patients infected with MDR-TB were foreign born and those infected are four times as likely to die from the disease and twice as likely to transmit the disease to others than other tuberculosis patients.

The researchers did not categorize the foreign-born patients as illegal aliens, but say the patients in question characteristically did not complete standard TB treatment and were in the United States less than five years at the time of diagnosis. Granich says multidrug-resistant TB was not associated with homelessness, incarceration, HIV/AIDS or using injected drugs.

Evidence of drug-resistant TB surfaced in 38 of 61 California health jurisdictions and could threaten the efficacy of TB control efforts, say the researchers, noting that an increasingly larger number of cases were turning up in rural or small-scale health facilities with limited resources.

The situation could add to the financial burdens of California and other states with a burgeoning immigrant population. States must honor the 1985 federal law guaranteeing emergency care regardless of citizenship or finances.

Source: Jennifer Harper, "TB seen in many aliens, study says," Washington Times, June 8, 2005.


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