Study objective: To characterize pulmonary and
extrapulmonary Mycobacterium tuberculosis cases in the
Somali community in Minnesota.
chart review of active tuberculosis cases in Somalis reported to the
Minnesota Department of Health between January 1993 and June 1998.
Patients: Ethnic Somalis in the state of Minnesota with
M tuberculosis diagnosed by positive culture or
radiographic findings consistent with tuberculosis and clinical
improvement when treated with antituberculous drugs.
Results: Eighty-two Somali patients were
diagnosed with tuberculosis during the study period. Extrapulmonary
disease (typically lymphadenopathy) was present in 46% (n = 38). The
1997 incidence of tuberculosis in Minnesota’s Somali population was
estimated at 170 cases per 100,000 population compared with a national
incidence of 20.5 per 100,000 among African Americans and 2.5 per
100,000 among whites. Ninety percent of Somali patients were < 40
years of age; 63% were diagnosed within 1 year of immigration, and>
90% had positive results with the purified protein derivative skin
test. M tuberculosis was confirmed in 24 of 25 isolates
from extrapulmonary cases. Multidrug resistance was present in 3.4%,
and only two patients had AIDS.
have a high incidence of active disease, with frequent extrapulmonary
involvement in the absence of AIDS, clinical presentation shortly after
immigration, and infrequent infection with resistant organisms.
Health-care providers should maintain an increased awareness for
tuberculosis when evaluating Somali immigrants.