Abstract
In 2010, foreign-born persons accounted for 60% of all tuberculosis (TB) cases in the United States. Understanding which national groups make up the highest proportion of TB cases will assist TB control programs in concentrating limited resources where they can provide the greatest impact on preventing transmission of TB disease. The objective of our study was to predict through 2020 the numbers of U.S. TB cases among U.S.-born, foreign-born and foreign-born persons from selected countries of birth. TB case counts reported through the National Tuberculosis Surveillance System from 2000–2010 were log-transformed, and linear regression was performed to calculate predicted annual case counts and 95% prediction intervals for 2011–2020. Data were analyzed in 2011 before 2011 case counts were known. Decreases were predicted between 2010 observed and 2020 predicted counts for total TB cases (11,182 to 8,117 [95% prediction interval 7,262–9,073]) as well as TB cases among foreign-born persons from Mexico (1,541 to 1,420 [1,066–1,892]), the Philippines (740 to 724 [569–922]), India (578 to 553 [455–672]), Vietnam (532 to 429 [367–502]) and China (364 to 328 [249–433]). TB cases among persons who are U.S.-born and foreign-born were predicted to decline 47% (4,393 to 2,338 [2,113–2,586]) and 6% (6,720 to 6,343 [5,382–7,476]), respectively. Assuming rates of declines observed from 2000–2010 continue until 2020, a widening gap between the numbers of U.S.-born and foreign-born TB cases was predicted. TB case count predictions will help TB control programs identify needs for cultural competency, such as languages and interpreters needed for translating materials or engaging in appropriate community outreach.
Highlights
The primary responsibility for treating, and oftentimes diagnosing, patients with tuberculosis (TB) and latent tuberculosis infection (LTBI) falls to state and local TB control programs [1]
Among all TB cases diagnosed in the United States, the proportion of cases among persons who were foreign-born was predicted to increase from 60% in 2010 to 78% by 2020
TB cases are predicted to decline among all persons in the U.S A steeper decline is predicted among U.S.-born than foreign-born persons, which has implications for state and local TB control programs and TB elimination in the U.S Among the top 5 countries of birth of foreign-born TB patients diagnosed in the United States, our model predicted a significant decrease and 2010 observed case count above the upper bound of the 2020 prediction interval only for foreign-born persons from Vietnam
Summary
The primary responsibility for treating, and oftentimes diagnosing, patients with tuberculosis (TB) and latent tuberculosis infection (LTBI) falls to state and local TB control programs [1]. As foreign-born persons make up an increasing proportion of TB cases in the United States, predicting TB trends will help TB control programs identify needs for cultural competency, including foreign language speakers and interpreters needed for translating materials or engaging in appropriate community outreach. As progress continues in decreasing the burden of TB in the United States [11], understanding TB trends among the foreign-born groups that make up the largest proportion of TB cases will assist TB control programs in concentrating limited resources where they can provide the greatest impact. The purpose of this study was to help guide TB control and program planning. We achieved this objective by predicting the numbers of U.S TB cases among
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