Prevalence of tuberculosis infection in the United States population - The National Health and Nutrition Examination Survey, 1999-2000
Prevalence of tuberculosis infection in the United States population - The National Health and Nutrition Examination Survey, 1999-2000
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DOI：
10.1164/rccm.200701-057oc
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发表时间：
2008-02-01
影响因子：
24.7
通讯作者：
Castro, Kenneth G.
中科院分区：
文献类型：
--
作者：
Bennett, Diane E.;Courval, Jeanne M.;Castro, Kenneth G.
在美国消除结核病的目标是到2010年结核病发病率低于1/100万美国人口，这要求潜伏性结核感染（LTBI）患病率低于1%，并不断下降。目的：估计美国人口中LTBI的患病率。方法和测量：1999-2000年，作为全国健康和营养检查调查的一部分，对7 386人进行了面谈和体检，包括结核菌素皮肤试验，非制度化的美国人口。LTBI定义为TST测量值>= 10 mm。评估年龄、种族/民族、性别、贫困和出生地的相关性。24- 74岁亚组的结果与NHANES 1971-1972 data. Measures和主要结果进行比较：估计LTBI患病率为4.2%，估计有11，213，000人患有LTBI。在25至74岁的人中，流行率从1971-1972年的14.3%下降到1999-2000年的5.7%。在外国出生的人（18.7%），非西班牙裔黑人/非洲裔美国人（7.0%），墨西哥裔美国人（9.4%）和生活在贫困中的人（6.1%）中观察到较高的患病率。LTBI中共有63%是外国出生的。在美国出生的人中，在调整混杂因素后，LTBI与非西班牙裔非洲裔美国人种族/民族，墨西哥裔美国人种族和贫困相关。共有25.5%的人与LTBI以前被诊断为有LTBI或TB，只有13.2%已规定treatment.Conclusions：除了基本的结核病控制措施，消除战略应包括有针对性的评估和治疗的个人在高患病率的群体，以及加强对全球结核病预防和控制的支持。
Rationale The goal for tuberculosis (TB) elimination in the United States is a TB disease incidence of less than 1 per million U.S. population by 2010, which requires that the latent TB infection (LTBI) prevalence be less than 1% and decreasing.Objectives: To estimate the prevalence of LTBI in the U.S. population.Methods and Measurements: Interviews and medical examinations, including tuberculin skin testing (TST), of 7,386 individuals were conducted in 1999-2000 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the civilian, noninstitutionalized U.S. population. LTBI was defined as a TST measurement of >= 10 mm. Associations of age, race/ethnicity, sex, poverty, and birthplace were assessed. Results among the 24- to 74-year-old subgroup were compared with NHANES 1971-1972 data.Measurements and Main Results: Estimated LTBI prevalence was 4.2%; an estimated 11,213,000 individuals had LTBI. Among 25- to 74-year-olds, prevalence decreased from 14.3% in 1971-1972 to 5.7% in 1999-2000. Higher prevalences were seen in the foreign born (18.7%), non-Hispanic blacks/African Americans (7.0%), Mexican Americans (9.4%), and individuals living in poverty (6.1%). A total of 63% of LTBI was among the foreign born. Among the U.S. born, after adjusting for confounding factors, LTBI was associated with non-Hispanic African-American race/ethnicity, Mexican American ethnicity, and poverty. A total of 25.5% of persons with LTBI had been previously diagnosed as having LTBI or TB, and only 13.2% had been prescribed treatment.Conclusions: In addition to basic TB control measures, elimination strategies should include targeted evaluation and treatment of individuals in high-prevalence groups, as well as enhanced support for global TB prevention and control.