Refugee Health Technical Assistance Center
Our March issue highlights tuberculosis in honor of World TB Day on March 24, 2012!  

Stop TB in My Lifetime

The Division of Tuberculosis Elimination, Centers for Disease Control (CDC) and Prevention contributed to this article.  


Each year, World TB Day is recognized on March 24th to commemorate the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB).  Worldwide, TB continues to be one of the world's deadliest diseases, with an estimated 2 billion persons infected with M. tuberculosis (one third of the world's population).  In 2010, almost 9 million people around the world became sick with TB disease, and 1.5 million died from it.  World TB Day provides an opportunity to raise awareness about TB-related problems and solutions, and to support worldwide TB-control efforts


This year, CDC joins the global Stop TB Partnership in adopting the slogan "Stop TB in my lifetime" that goes with the theme of calling for a world free of TB.  The slogan and theme encourage people all over the world, from the youngest to the oldest, to make an individual call for the elimination of TB, and say what changes they expect to take place in their lifetimes.


Disparities continue to exist between TB rates in U.S.-born whites compared with racial and ethnic minorities and foreign-born persons in the United States. In 2010, the TB rate among foreign-born persons was 11 times greater than that of U.S.-born persons. Additionally, the prevalence of drug-resistant TB and extrapulmonary disease is higher among foreign-born persons, making the diagnosis and management of these cases essential to TB control and prevention.     


In an effort to educate and raise awareness about TB, CDC's Division of Tuberculosis Elimination has developed a variety of online resources in English and Spanish to assist partners in developing their own World TB Day messages and materials. Learn more about CDC's global TB control activities >


In the Literature

Estimating the impact of newly arrived foreign-born persons on tuberculosis in the United States. Liu, Y., Painter, J.A., Posey, D.L., Cain, K.P., Weinberg, M.S., Maloney, S.A., et al. 2012. PLoS One, 7(2), e32158.


Overseas screening for tuberculosis in U.S.-bound immigrants and refugees. Liu, Y., Weinberg, M. S., Ortega, L. S., Painter, J. A., & Maloney, S. A. 2009. N Engl J Med, 360(23), 2406-2415. 


Reduced importation of tuberculosis after the implementation of an enhanced pre-immigration screening protocol. Lowenthal, P., Westenhouse, J., Moore, M., Posey, D. L., Watt, J. P., & Flood, J. (2011). Int J Tuberc Lung Dis, 15(6), 761-766.


Trends in tuberculosis -- United States, 2010. MMWR. 60(11), 333-337.


Perceptions of tuberculosis among immigrants and refugees at an adult education center: a community-based participatory research approach. Wieland, M. L., Weis, J. A., Yawn, B. P., Sullivan, S. M., Millington, K. L., Smith, C. M., et al. (2012). J Immigr Minor Health, 14(1), 14-22

Scam Alert
Perpetrators of national telephone scams continue to target refugees. The scams vary slightly in nature but all attempt to persuade their targets to give personal or financial information. Everyone is advised to be extra-vigilant with unsolicited calls. File an online report at if you are the target of a scam call. Get more details >
What Interests You? 

The RHTAC Community Dialogue is a place for refugee-serving providers to share perspectives on refugee health issues. Let us know a refugee health topic that you want to discuss and we'll do our best to make it happen. Suggest a topic > 

Affordable Care Act & Refugee Health
Protecting Refugees with Pre-Existing Conditions

What is a "pre-existing condition"? Why is it important?

A "pre-existing condition" is a physical or mental health condition, disability, or illness that a person has before they enroll in a health plan. Insurance companies may deny coverage, exclude benefits, or charge higher premiums if a person has a pre-existing condition. Refugees may have pre-existing conditions that result from limited access to health care during the migration process. 

How does the Affordable Care Act help people with pre-existing conditions? 

Today, children under 19 years old with pre-existing conditions are protected under the Affordable Care Act and insurance companies cannot deny coverage based on that condition. Starting in 2014, this protection will extend to all Americans regardless of age, including resettled refugees. The Pre-Existing Condition Insurance Plan helps to make health insurance available to people who have been denied coverage by private insurance companies because of a pre-existing condition.


Upcoming RHTAC Webinars
Addressing the Language Access Barrier When Serving Refugee Patients

Wednesday, March 28, 2012

1:00 - 2:30 PM EST

Presented by: Cindy Roat, MPH, National Language Access Consultant.   

Register now >    


Refugees and the Affordable Care Act: Preparing the Resettlement Network for 2014

Thursday, April 5, 2012

1:00 - 2:30 PM EST

Presented by: Lauren Block and Anne Marie Costello, Centers for Medicare & Medicaid Services    

Register now > 


Mental Health Interpreting - Save the date!

Wednesday, April 25, 2012

1:00 - 2:30 PM EST  

Presented by: Joy Connell, President, National Council on Interpreting in Health Care.   


Infectious Disease Case Studies

Wednesday, May 9, 2012

1:00 - 2:30 PM EST

Presented by: Elizabeth Barnett, MD, Professor of Pediatrics, Boston University School of Medicine.

Details: CECs available.   

Register now > 

Upcoming Events   

African Refugee and Immigrant Lives: Conflict, Consequences, and Contributions 

May 2-4, 2012, Arlington, VA 

Presented by: The Ethiopian Community Development Council (ECDC) Center for African Refugees and Immigrants (CARI). 


North American Refugee Healthcare Conference - Registration now open!

June 28-30, 2012, Rochester, NY

Presented by: Rochester General Hospital.  

Submit an abstract! 


National Immigrant Integration Conference 

September 22-25, 2012, Baltimore, MD
Presented by: The National Partnership for New Americans.
Global Mental Health: Trauma and Recovery Training Program
On-site Learning: November 4-17, 2012, Orvieto, Italy
Web-based Learning: November 2012 - May 2013
Funding Opportunities

Assets for Independence Demonstration Program

Spring Cycle due March 26, 2012. Support for community-based organizations to offer Individual Development Accounts (matched savings accounts), financial education, and related services to low-income individuals and families, in order for them to accumulate savings and invest in appreciating assets such as a first home, small business, or higher education or training.


Services to Victims of Human Trafficking Grant

Due April 17, 2012. $200,000 to $400,000 for victim service organizations to provide services to human trafficking victims and to enhance interagency collaboration and coordination in the provision of services. Funding will support either a comprehensive array of services for trafficking victims or specialized mental health or legal services; as well as efforts to increase the capacity of communities to respond to victims through partnerships, outreach, and awareness campaigns.   

Victim Services Grant 

Due April 25, 2012. Up to $250,000 to develop and implement online national-scope training and technical assistance to strengthen the capacity of victim service and ancillary service providers.

RHTAC is a project of the Refugee and Immigrant Health Program, Massachusetts Department of Public Health, in collaboration with the Center for Refugee Trauma and Resilience at Children's Hospital Boston, the Bellevue/NYU Program for Survivors of Torture, the Cultural Orientation Resource Center at Center for Applied Linguistics, and JSI Research and Training Institute, Inc. RHTAC is funded by the Office of Refugee Resettlement, Administration for Children and Families, U.S. Department of Health and Human Services. Grant #90RB0042.    


For more information, please email

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Guidelines for Screening for Tuberculosis Infection and Disease during the Domestic Medical Examination for Newly Arrived Refugees

Centers for Disease Control and Prevention. 
An overview of overseas pre-departure screening, domestic refugee screening, diagnostic classifications, and treatments for TB.      


Monitoring and Evaluation Tool for Tuberculosis Programs in Refugee and Post-Conflict Settings
Centers for Disease Control and Prevention & International Rescue Committee.
Tool designed to support the effective monitoring and evaluation of TB control programs in refugee camps and other settings located in resource-poor areas.

TB Ethnographic Guides
Centers for Disease Control and Prevention.

Guides available for Burma, China, Laos (Hmong), Mexico, Somalia, and Vietnam.

World Health Organization (WHO).
Profiles available for all countries/territories asked to report TB data to WHO.  

Southeastern National Tuberculosis Center.
Guides for numerous countries including Cambodia, Myanmar, and Somalia.

Cultural Competency in Tuberculosis Care
New Jersey Medical School Global Tuberculosis Institute.
A guide for self-study and self-assessment to prepare health care providers and public health staff for working with diverse populations. 

Making the Connection: An Introduction to Interpretation Skills for TB Control, 2nd edition
University of California San Francisco.

Video designed to help TB control program staff work effectively with interpreters.


Materials available in languages such as Khmer, Somali, and Vietnamese.
Centers for Disease Control and Prevention.
A library of online TB resources, trainings, and educational materials.

TB Regional Training and Medical Consultation Centers (RTMCCs) 

Centers for Disease Control and Prevention. 
Each RTMCC develops TB educational materials and provides training, technical assistance, and medical consultation to TB programs and medical providers.  


Webinar Archive     

Strong Roots and Bright Futures: Promoting Successful Adjustment for Refugee Youth 

February 8, 2012  


Adapting QPR Training to Incorporate Refugee Experiences 

January 31, 2012 


Tools and Strategies for Refugee Mental Health Screening: Introducing the RHS-15

January 25, 2012 


Clinical Care to Refugees with HIV Infection 

November 30, 2011


Domestic Refugee Health Screening Models and Clinical Guidelines

October 26, 2011


Addressing the Mental Health Needs of Refugees in Primary Care Settings

July 27, 2011


HIV and Refugee Resettlement  

June 23, 2011

Suicide Among Refugees: Understanding the Social and Cultural Context for Prevention Strategies

May 17, 2011   


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