Changes in tuberculosis epidemiology, United States, 1993-2017
Changes in tuberculosis epidemiology, United States, 1993-2017
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DOI：
10.5588/ijtld.18.0757
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发表时间：
2019-07-01
影响因子：
4
通讯作者：
Navin, T. R.
中科院分区：
文献类型：
--
作者：
Armstrong, L. R.;Winston, C. A.;Navin, T. R.
背景技术背景：经过20年的稳步下降，结核病（TB）发病率下降的步伐在美国已经放缓。方法：自1993年以来，结核病发病率和病例数的趋势进行了评估，使用美国国家监测数据。结果：自2012年以来，结核病发病率和病例数年平均下降率分别为2.2%（95%CI-3.4 ~-1.0）和1.5%（95%CI-2.7 ~-0.3），其中美国出生者下降，非美国出生者无变化。总体而言，在2014-2017年期间诊断出结核病的人年龄较大，比单独的肺外疾病更有可能患有肺和肺外疾病，更有可能是非白人种族，并且不太可能患有人类免疫缺陷病毒感染或空洞性肺病。在2014-2017年期间，非美国出生的结核病患者更有可能患有糖尿病，而美国出生的结核病患者更有可能患有涂阳结核病并使用非注射药物。结论：流行病学趋势的变化可能会影响未来几十年的结核病发病率。疾病控制和预防中心呼吁通过检测和治疗潜伏性结核感染来加强对结核病预防的关注。
BACKGROUND: After 20 years of steady decline, the pace of decline of tuberculosis (TB) incidence in the United States has slowed.METHODS : Trends in TB incidence rates and case counts since 1993 were assessed using national US surveillance data. Patient characteristics reported during 2014-2017 were compared with those for 2010-2013.RESULTS : TB rates and case counts slowed to an annual decline of respectively 2.2% (95%CI -3.4 to -1.0) and 1.5% (95%CI -2.7 to -0.3) since 2012, with decreases among US-born persons and no change among non-US-born persons. Overall, persons with TB diagnosed during 2014-2017 were older, more likely to have combined pulmonary and extra-pulmonary disease than extra-pulmonary disease alone, more likely to be of non-White race, and less likely to have human immunodeficiency virus infection, or cavitary pulmonary disease. During 2014-2017, non-US-born persons with TB were more likely to have diabetes mellitus, while the US-born were more likely to have smear-positive TB and use non-injecting drugs.CONCLUSION: Changes in epidemiologic trends are likely to affect TB incidence in the coming decades. The Centers for Disease Control and Prevention has called for increased attention to TB prevention through the detection and treatment of latent tuberculous infection.