Tuberculosis among foreign-born persons in the United States
Tuberculosis among foreign-born persons in the United States
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DOI：
10.1001/jama.300.4.405
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发表时间：
2008-07-23
影响因子：
120.7
通讯作者：
Mac Kenzie, William R.
中科院分区：
文献类型：
--
作者：
Cain, Kevin P.;Benoit, Stephen R.;Mac Kenzie, William R.
2006年，在美国，外国出生的人占所有结核病（TB）病例的57%。目前的结核病控制策略还没有充分解决高水平的结核病和潜伏性结核病感染在这population. ObjectiveTo确定结核病和耐药结核病的风险在外国出生的人口和潜在的影响，增加结核病文化的海外筛查程序外国出生的人进入美国。研究对象：对2001 - 2006年在美国被诊断为结核病的外国出生者进行描述性流行病学分析。主要结果：测量结核病病例率，按进入美国的时间、原籍国和进入美国时的年龄分层;结果从2001年到2006年，在美国出生的外国人中共报告了46970例结核病病例，其中12928例（28%）是最近入境者（入境后2年内）。在外国出生的总体人口中，结核病病例率自进入美国以来随着时间的推移而下降，但仍然高于美国出生的人-甚至在抵达美国20多年后。总体而言，53%的外国出生者结核病病例发生在撒哈拉以南非洲和东南亚出生的22%的外国出生人口中。异烟肼耐药性高达20%，最近从越南和18%，最近从秘鲁入境者。平均而言，每年有250个人被诊断为痰涂片阴性，培养阳性结核病3个月内，美国入境，其中46%来自菲律宾或Vietnam.Conclusion发现和治疗潜伏性结核病感染的相对产量是特别高的个人从撒哈拉以南非洲和东南亚的大多数国家。
Context Foreign-born persons accounted for 57% of all tuberculosis (TB) cases in the United States in 2006. Current TB control strategies have not sufficiently addressed the high levels of TB disease and latent TB infection in this population.Objective To determine the risk of TB disease and drug-resistant TB among foreign-born populations and the potential impact of adding TB culture to overseas screening procedures for foreign-born persons entering the United States.Design, Setting, and Participants Descriptive epidemiologic analysis of foreign-born persons in the United States diagnosed with TB from 2001 through 2006.Main Outcome Measures TB case rates, stratified by time since US entry, country of origin, and age at US entry; anti-TB drug-resistance patterns; and characteristics of TB cases diagnosed within 3 months of US entry.Results A total of 46 970 cases of TB disease were reported among foreign-born persons in the United States from 2001 through 2006, of which 12 928 (28%) were among recent entrants (within 2 years of US entry). Among the foreign-born population overall, TB case rates declined with increasing time since US entry, but remained higher than among US-born persons - even more than 20 years after arrival. In total, 53% of TB cases among foreign-born persons occurred among the 22% of the foreign-born population born in sub-Saharan Africa and Southeast Asia. Isoniazid resistance was as high as 20% among recent entrants from Vietnam and 18% for recent entrants from Peru. On average, 250 individuals per year were diagnosed with smear-negative, culture-positive TB disease within 3 months of US entry; 46% of these were from the Philippines or Vietnam.Conclusion The relative yield of finding and treating latent TB infection is particularly high among individuals from most countries of sub-Saharan Africa and Southeast Asia.