Document 0055
 DOCN  M9490055
 TI    Epidemiology of tuberculosis in the United States, 1985 through 1992.
 DT    9411
 AU    Cantwell MF; Snider DE Jr; Cauthen GM; Onorato IM; Division of
       Tuberculosis Elimination, Centers for Disease Control; and Prevention,
       Atlanta, GA 30333.
 SO    JAMA. 1994 Aug 17;272(7):535-9. Unique Identifier : AIDSLINE
       MED/94322450
 AB    OBJECTIVE--To examine the distribution and sources of increased
       tuberculosis (TB) morbidity in the United States from 1985 through 1992.
       DESIGN--Review of TB surveillance data. PARTICIPANTS--All incident TB
       cases in the United States reported to the Centers for Disease Control
       and Prevention from 1980 through 1992. MAIN OUTCOME MEASURES--Changes in
       reported number of TB cases from 1985 through 1992 were analyzed by sex,
       race/ethnicity, age, county of birth (1986 through 1992), site of
       disease, geographic location, and socioeconomic status (through 1991).
       From 1985 through 1992, reported number of cases was compared with
       expected number of cases, extrapolated from 1980 through 1984 trends, to
       estimate excess cases by sex, race/ethnicity, and age.
       RESULTS--Increases in number of cases from 1985 through 1992 were
       concentrated among racial/ethnic minorities, persons 25 to 44 years of
       age, males, and the foreign-born. Excess cases occurred in both sexes,
       all racial/ethnic groups, and all age groups. Foreign-born cases
       accounted for 60% of the total increase in the number of US cases from
       1986 through 1992 and had the greatest impact among Asians, Hispanics,
       females, and persons other than those 25 to 44 years of age. Human
       immunodeficiency virus infection had the greatest impact on TB morbidity
       among whites, blacks, males, and persons 25 to 44 years of age. From
       1985 through 1992, the number of cases among children 4 years old or
       younger increased 36%, suggesting that transmission of TB increased
       during this period. CONCLUSIONS--Multiple factors contributed to the
       recent increases in the number of TB cases. The effectiveness of TB
       screening in immigrants needs further evaluation. Intensified efforts to
       determine the human immunodeficiency virus status of persons with TB are
       needed. Screening of subpopulations at increased risk for tuberculous
       infection or TB should be expanded.
 DE    Adolescence  Adult  Age Distribution  Aged  Centers for Disease Control
       and Prevention (U.S.)  Child  Child, Preschool  Comorbidity  Demography
       Emigration and Immigration/STATISTICS & NUMER DATA  Female  Human  HIV
       Infections/EPIDEMIOLOGY  Infant  Linear Models  Male  Middle Age
       Morbidity  Regression Analysis  Sex Distribution  Socioeconomic Factors
       Tuberculosis/*EPIDEMIOLOGY  United States/EPIDEMIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).