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1994-09-03
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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).