Authors: Manangan, L.¹; Elmore, K.²; Lewis, B.²; Pratt, R.³; Armstrong, L.¹; Davison, J.⁴; Santibanez, S.⁵; Heetderks, A.¹; Robison, V.¹; Lee, V.²; Navin, T.¹

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 9, September 2009 , pp. 1077-1085(9)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: The United States (US) National Tuberculosis Surveillance System (NTSS), including 50 states, District of Columbia, and New York City.

OBJECTIVE: To examine disparities in characteristics and rates of Asian/Pacific Islander (API) and non-Hispanic White tuberculosis (TB) patients.

DESIGN: Descriptive analysis and logistic regression of selected 1993-2006 NTSS data. US Census Bureau Zip Code Tabulation Areas and geographic information system were used to compare API and non-Hispanic White TB patients by population density.

RESULT: Of 253 299 TB cases, 19.8% were APIs and 23.2% were Whites; 94.2% APIs and 11.9% Whites were foreign-born. Factors that were most often associated with APIs were being female, age 15-24 years, extra-pulmonary TB, and drug resistance. APIs were less likely than Whites to be human immunodeficiency virus (HIV) positive, homeless, substance abusers, or on directly observed therapy. From 1993 to 2006, the API TB case rate declined by 42.9% vs. 66.6% in Whites (P < 0.01). Being foreign-born was the strongest risk factor for TB, regardless of population densities, but APIs were more likely to have TB than foreign-born Whites at lower population densities.

CONCLUSION: Disparities in TB exist among US APIs and non-Hispanic Whites. TB program officials should allocate programs appropriately for foreign-born APIs in lower population density areas.

Keywords: Asian/Pacific Islander; tuberculosis; health disparities; non-Hispanic White

Document Type: Regular paper

Affiliations: 1: Division of Tuberculosis Elimination, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2: Geospatial Research, Analysis, and Services Program, Division of Health Studies, National Center for Environmental Health-Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3: Centers for Disease Control and Prevention Information Technology Support Contractor, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 4: Rollins School of Public Health, Emory University, Atlanta, Georgia, USA 5: Office of Health Disparities, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Publication date: 2009-09-01

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• 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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