文章基本信息

标题：Tuberculosis Incidence Among Populations at High Risk in California, Florida, New York, and Texas, 2011–2015
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作者：Sarah T. Cherng ; Sourya Shrestha ; Sue Reynolds 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2018
卷号：108
期号：Suppl 4
页码：S311-S314
DOI：10.2105/AJPH.2018.304503
语种：English
出版社：American Public Health Association
摘要：Objectives. To illustrate the magnitude of between-state heterogeneities in tuberculosis (TB) incidence among US populations at high risk for TB that may help guide state-specific strategies for TB elimination. Methods. We used data from the National Tuberculosis Surveillance System and other public sources from 2011 to 2015 to calculate TB incidence in every US state among people who were non–US-born, had diabetes, or were HIV-positive, homeless, or incarcerated. We then estimated the proportion of TB cases that reflected the difference between each state’s reported risk factor–specific TB incidence and the lowest incidence achieved among 4 states (California, Florida, New York, Texas). We reported these differences for the 4 states and also calculated and aggregated across all 50 states to quantify the total percentage of TB cases nationally that reflected between-state differences in risk factor–specific TB incidence. Results. On average, 24% of recent TB incidence among high-risk US populations reflected heterogeneity at the state level. The populations that accounted for the greatest percentage of heterogeneity-reflective cases were non–US-born individuals (51%) and patients with diabetes (24%). Conclusions. State-level differences in TB incidence among key populations provide clues for targeting state-level interventions. The United States experienced an average annual decline in tuberculosis (TB) incidence of more than 5% from 1993 to 2014. 1 However, between 2014 and 2016, TB incidence remained essentially flat, at approximately 3.0 cases per 100 000 people per year. 2 To better understand trends and continue progress toward elimination (< 1 case/million people/year), 3 it may be useful to identify heterogeneities in TB incidence between states among high-risk populations. 4 Describing the magnitude of such heterogeneity by specific risk factors can provide insights for officials to tailor TB control and prevention activities to the unique public health requirements of each state. Some sources of observed heterogeneity may be unmodifiable, but other components may be actionable. These results can inform state-level investigations and help develop effective targeted interventions. We therefore sought to quantify the differences in TB incidence within selected populations in all 50 US states, benchmarked against TB incidence in 1 of 4 states (California, Texas, New York, Florida). These 4 states currently account for more than half of all new TB cases in the United States and contain large and heterogeneous populations at high risk for TB disease relative to most other states.