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Disparities in Tuberculosis Incidence by Race and Ethnicity Among the U.S.-Born Population in the United States, 2011 to 2021 : An Analysis of National Disease Registry Data.
Li, Yunfei; Regan, Mathilda; Swartwood, Nicole A; Barham, Terrika; Beeler Asay, Garrett R; Cohen, Ted; Hill, Andrew N; Horsburgh, C Robert; Khan, Awal; Marks, Suzanne M; Myles, Ranell L; Salomon, Joshua A; Self, Julie L; Menzies, Nicolas A.
Afiliação
  • Li Y; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Y.L., M.R., N.A.S.).
  • Regan M; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Y.L., M.R., N.A.S.).
  • Swartwood NA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Y.L., M.R., N.A.S.).
  • Barham T; Office of Health Equity, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (T.B., R.L.M.).
  • Beeler Asay GR; Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia (G.R.B.A., A.N.H., A.K., S.M.M., J.L.S.).
  • Cohen T; Yale School of Public Health, New Haven, Connecticut (T.C.).
  • Hill AN; Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia (G.R.B.A., A.N.H., A.K., S.M.M., J.L.S.).
  • Horsburgh CR; Departments of Epidemiology, Biostatistics, Global Health and Medicine, Boston University Schools of Public Health and Medicine, Boston, Massachusetts (C.R.H.).
  • Khan A; Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia (G.R.B.A., A.N.H., A.K., S.M.M., J.L.S.).
  • Marks SM; Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia (G.R.B.A., A.N.H., A.K., S.M.M., J.L.S.).
  • Myles RL; Office of Health Equity, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (T.B., R.L.M.).
  • Salomon JA; Department of Health Policy, Stanford School of Medicine, Stanford University, Stanford, California (J.A.S.).
  • Self JL; Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia (G.R.B.A., A.N.H., A.K., S.M.M., J.L.S.).
  • Menzies NA; Department of Global Health and Population and Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (N.A.M.).
Ann Intern Med ; 177(4): 418-427, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38560914
ABSTRACT

BACKGROUND:

Elevated tuberculosis (TB) incidence rates have recently been reported for racial/ethnic minority populations in the United States. Tracking such disparities is important for assessing progress toward national health equity goals and implementing change.

OBJECTIVE:

To quantify trends in racial/ethnic disparities in TB incidence among U.S.-born persons.

DESIGN:

Time-series analysis of national TB registry data for 2011 to 2021.

SETTING:

United States.

PARTICIPANTS:

U.S.-born persons stratified by race/ethnicity. MEASUREMENTS TB incidence rates, incidence rate differences, and incidence rate ratios compared with non-Hispanic White persons; excess TB cases (calculated from incidence rate differences); and the index of disparity. Analyses were stratified by sex and by attribution of TB disease to recent transmission and were adjusted for age, year, and state of residence.

RESULTS:

In analyses of TB incidence rates for each racial/ethnic population compared with non-Hispanic White persons, incidence rate ratios were as high as 14.2 (95% CI, 13.0 to 15.5) among American Indian or Alaska Native (AI/AN) females. Relative disparities were greater for females, younger persons, and TB attributed to recent transmission. Absolute disparities were greater for males. Excess TB cases in 2011 to 2021 represented 69% (CI, 66% to 71%) and 62% (CI, 60% to 64%) of total cases for females and males, respectively. No evidence was found to indicate that incidence rate ratios decreased over time, and most relative disparity measures showed small, statistically nonsignificant increases.

LIMITATION:

Analyses assumed complete TB case diagnosis and self-report of race/ethnicity and were not adjusted for medical comorbidities or social determinants of health.

CONCLUSION:

There are persistent disparities in TB incidence by race/ethnicity. Relative disparities were greater for AI/AN persons, females, and younger persons, and absolute disparities were greater for males. Eliminating these disparities could reduce overall TB incidence by more than 60% among the U.S.-born population. PRIMARY FUNDING SOURCE Centers for Disease Control and Prevention.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose / Etnicidade Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: Ann Intern Med Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose / Etnicidade Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: Ann Intern Med Ano de publicação: 2024 Tipo de documento: Article