The impact of migration on tuberculosis in the United States
Due to greater exposure to Mycobacterium tuberculosis infection before migration, migrants moving to low-incidence settings can experience substantially higher tuberculosis (TB) rates than the native-born population. This review describes the impact of migration on TB epidemiology
in the United States, and how the TB burden differs between US-born and non-US-born populations. The United States has a long history of receiving migrants from other parts of the world, and TB among non-US-born individuals now represents the majority of new TB cases. Based on an analysis
of TB cases among individuals from the top 30 countries of origin in terms of non-US-born TB burden between 2003 and 2015, we describe how TB risks vary within the non-US-born population according to age, years since entry, entry year, and country of origin. Variation along each of these dimensions
is associated with more than 10-fold differences in the risk of developing active TB, and this risk is also positively associated with TB incidence estimates for the country of origin and the composition of the migrant pool in the entry year. Approximately 87 000 lifetime TB cases are
predicted for the non-US-born population resident in the United States in 2015, and 5800 lifetime cases for the population entering the United States in 2015.
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Document Type: Research Article
Department of Global Health and Population, Center for Health Decision Science, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
Division of TB Elimination, US Centers for Disease Control and Prevention, Atlanta, Georgia
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University, Stanford, California, USA
Publication date: December 1, 2018
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