Differential decline in tuberculosis incidence among US- and non-US-born persons in New York City
Abstract:SETTING: A large urban tuberculosis control program.
OBJECTIVES: To examine changes in tuberculosis incidence and characteristics of cases in New York City (NYC), and assess the epidemiology of tuberculosis among non-US-born persons.
DESIGN: Tuberculosis surveillance data (1995–1999) for NYC were analyzed.
RESULTS: Tuberculosis incidence decreased by 56.6% in US-born and 19.6% in non-US-born persons (age-adjusted) over the study period. The decline in tuberculosis incidence among US-born persons was more substantial in the first half of the study period (23–24%) than in the second half (13–15%). The greatest decline in incidence was among US-born Hispanic or Black males aged 25–64. However, although there was an overall decline in incidence among non-US-born persons, there was no significant change in any sex or racial/ethnic subgroup. The percent of multidrug-resistant (MDR) cases among non-US-born patients remained stable, but recent arrivals accounted for 79% of non-US-born MDR-TB patients in 1999, a significant increase from 16% in 1997.
CONCLUSIONS: Continuing current tuberculosis control efforts and treatment of immigrants with latent tuberculosis infection are of highest priority for reducing incident cases in NYC. Global collaboration towards earlier detection and treatment of active tuberculosis cases in high incidence countries is also essential.
Document Type: Regular Paper
Affiliations: 1: Tuberculosis Control Program, New York City Department of Health, New York, New York, USA 2: Tuberculosis Control Program, New York City Department of Health, New York, New York, USA; and Mailman School of Public Health, Columbia University, New York, New York, USA 3: Mailman School of Public Health, Columbia University, New York, New York, USA 4: Tuberculosis Control Program, New York City Department of Health, New York, New York, USA; and Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Publication date: May 1, 2003
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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