PubMed · 8966607
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G K Pullum. 1996-11-29. The "Greenberg hypothesis".. https://pubmed.ncbi.nlm.nih.gov/8966607/
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BACKGROUND: Overseas screening of immigrants and refugees applying for a visa to the United States identifies foreign-born individuals who are at high risk for tuberculosis (TB) or who have active TB. The system's effectiveness relies on further medical evaluation and follow-up of foreign-born individuals after their arrival in the United States. METHODS: Retrospective cohort study of 893 immigrants and refugees who arrived in the United States from July 1, 1992, through December 31, 1993, with a destination of San Francisco, Calif, and a referral for further medical evaluation. MAIN OUTCOME MEASURES: Time to report to the local health department after arrival and the yield of active and preventable cases of TB from follow-up medical evaluations. RESULTS: Median time from arrival in the United States to seeking care in San Francisco was 9 days (range, 1-920 days). Of 745 immigrants and refugees (83.4%) who sought further medical evaluation, 51 (6.9%) had active TB and 296 (39.7%) were candidates for preventive therapy. Being a refugee was an independent predictor of failure to seek further medical evaluation in the United States. Class B-1 disease status based on overseas TB screening (odds ratio, 3.5; 95% confidence interval, 2.0-6.2) and being from mainland China (odds ratio, 4.4; 95% confidence interval, 1.9-9.9) were independent predictors of TB diagnosed in San Francisco. CONCLUSIONS: Timely, adequate medical evaluation and follow-up care of immigrants and refugees has a relatively high yield and should be a high priority for TB prevention and control programs.
OBJECTIVE: To answer the question whether positive selection of (pre)schizophrenic Surinams in Surinam before emigration to the Netherlands can explain the high admission rates for schizophrenia of Surinams in the Netherlands. DESIGN: Retrospective research. SETTING: 's Lands Psychiatrisch Ziekenhuis (National Psychiatric Hospital) Paramaribo, Surinam (LPZ). METHOD: The Netherlands Central Bureau of Statistics in Voorburg and the Central Registry Office in Paramaribo provided data on emigration to the Netherlands of the Surinam population and on remigration. Files of (pre)schizophrenic patients were selected from the records of LPZ. Subsequently, these patients were traced and their pattern of migration was studied. Using the chi 2 test the significance of observed differences was assessed. RESULTS: Surinam (pre)schizophrenic patients did not emigrate more frequently to the Netherlands (6.3%) compared with the Surinam population in general (9.6%) and they remigrated more frequently to Surinam than the Surinams in general. CONCLUSION: The positive selection hypothesis must be rejected.
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