Trends, Mechanisms, and Racial/Ethnic Differences of Tuberculosis Incidence in the US-Born Population Aged 50 Years or Older in the United States

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Kim, Sun ; Cohen, Ted ; Horsburgh, C. Robert ; Miller, Jeffrey W. ; Hill, Andrew N. ; Marks, Suzanne M. ; Li, Rongxia ; Kammerer, J. Steve ; Salomon, Joshua A. ; Menzies, Nicolas A.
• Description:
  Background.
  
  Older age is a risk factor for tuberculosis (TB) in low incidence settings. Using data from the US National TB Surveillance System and American Community Survey, we estimated trends and racial/ethnic differences in TB incidence among US-born cohorts aged ≥50 years.
  
  Methods.
  
  In total, 42 000 TB cases among US-born persons ≥50 years were reported during 2001–2019. We used generalized additive regression models to decompose the effects of birth cohort and age on TB incidence rates, stratified by sex and race/ethnicity. Using genotype-based estimates of recent transmission (available 2011–2019), we implemented additional models to decompose incidence trends by estimated recent versus remote infection.
  
  Results.
  
  Estimated incidence rates declined with age, for the overall cohort and most sex and race/ethnicity strata. Average annual percentage declines flattened for older individuals, from 8.80% (95% confidence interval [CI] 8.34–9.23) in 51-year-olds to 4.51% (95% CI 3.87–5.14) in 90-year-olds. Controlling for age, incidence rates were lower for more recent birth cohorts, dropping 8.79% (95% CI 6.13–11.26) on average between successive cohort years. Incidence rates were substantially higher for racial/ethnic minorities, and these inequalities persisted across all birth cohorts. Rates from recent infection declined at approximately 10% per year as individuals aged. Rates from remote infection declined more slowly with age, and this annual percentage decline approached zero for the oldest individuals.
  
  Conclusions.
  
  TB rates were highest for racial/ethnic minorities and for the earliest birth cohorts and declined with age. For the oldest individuals, annual percentage declines were low, and most cases were attributed to remote infection.
  
  
• Subjects:
  Age Groups Article Child Cohort Studies Disease Progression Ethnicity Health Status Disparities Humans Incidence Latent Tuberculosis Population Surveillance Race Factors Tuberculosis United States

  More +
• Source:
  Clin Infect Dis. 74(9):1594-1603
• Pubmed ID:
  34323959
• Pubmed Central ID:
  PMC8799750
• Document Type:
  Journal Article
• Funding:
  R01 AI146555/AI/NIAID NIH HHSUnited States/ ; U38 PS004644/PS/NCHHSTP CDC HHSUnited States/ ; UL1 TR001863/TR/NCATS NIH HHSUnited States/
• Volume:
  74
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:614c7890ee72b1d549c9cfe9a6d72d1077745e26e9a750fac4436fdb8eace1a9
• Download URL:
  https://stacks.cdc.gov/view/cdc/113976/cdc_113976_DS1.pdf
• File Type:
  [PDF - 1.07 MB ]