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Assessing Health Barriers for Afghan Refugees with Tuberculosis in Allegheny County

Singh, Amrit (2023) Assessing Health Barriers for Afghan Refugees with Tuberculosis in Allegheny County. Master Essay, University of Pittsburgh.

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While the incidence and prevalence of Tuberculosis (TB) in the United States have
decreased since the mid-20th century, it continues to be a global problem in many poorer countries.
Of the countries that are still burdened by TB, Afghanistan is particularly concerning. Since the
withdrawal of U.S. military troops from Afghanistan in 2021, nearly 800 Afghan refugees
immigrated to Allegheny County, Pennsylvania. Of these Afghan refugees, 74 have been referred
to the Allegheny County Health Department (ACHD) for evaluation. All TB tests for the refugees
in Allegheny County were performed by the ACHD or the Squirrel Hill Health Center (SHHC),
specifically through QuantiFERON-TB Gold tests (QFT). Afghan refugees confirmed positive for
TB were given medical evaluations by the ACHD or SHHC, and prescribed Rifampin or Isoniazid
medications if necessary. While this treatment practice has become standard, there is limited
research about health barriers the Afghan refugees with TB in Allegheny County may have faced.
This pilot study examined these potential barriers, such as language, social, and cultural
adjustments the refugees may have struggled with, and proposed recommendations for addressing
said barriers. A survey was implemented, in which 74 Afghan refugees aged 13-63 years were
asked about their TB health literacy, communication to their Primary Care Providers (PCP’s),
treatment regimens, social/cultural/housing adjustments, and overall quality of health care
received. Pearson’s Chi-Squared tests were used to evaluate and compare proportions for the
barriers and the refugees’ self-reported answers, with survey responses stratified by age and
Results indicated 98.7% (n=73) of refugees reported that they had difficulty adjusting to
American social norms and 96.0% (n=71) reported that they had difficulty learning English.
Despite the more robust health care system and treatment methods in the United States as compared
to Afghanistan, there is room for improvement for treating refugee populations. The Afghan
refugee community in Allegheny County could benefit from improved language and social
assistance, particularly for those who live in isolation due to having TB. Overall, this study
attempted to identify reported barriers faced by Afghan refugees with TB in Allegheny County,
and propose recommendations to address this public health issue.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Singh, Amritams790@pitt.eduams790
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairGlynn, Nancyepidnwg@pitt.eduepidnwgUNSPECIFIED
Committee MemberBaumann, Sarasarabaumann@pitt.edusarabaumannUNSPECIFIED
Committee MemberBrungo, LaurenLauren.Brungo@AlleghenyCounty.USUNSPECIFIEDUNSPECIFIED
Date: 5 January 2023
Date Type: Completion
Number of Pages: 41
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: No
Date Deposited: 05 Jan 2023 14:12
Last Modified: 05 Jan 2023 14:12


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