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Epidemiology of tuberculosis (TB) among children and adolescents in the United States, 2007–2017: an analysis of national surveillance data
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10-2019
Source: Lancet Public Health. 4(10):e506-e516 -
Alternative Title:Lancet Public Health
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Description:Background.
Understanding tuberculosis (TB) epidemiology among children and adolescents informs treatment and prevention efforts and efforts to eliminate disparities in TB incidence and mortality. We sought to describe the epidemiology of children and adolescents with TB disease in the United States (U.S.), including TB incidence rates by parental country of birth and for U.S. territories and freely associated states, which have not been previously described.
Methods.
We analyzed data for children aged <15 and adolescents aged 15–17 years with TB disease reported to the National Tuberculosis Surveillance System during 2007–2017, and calculated TB incidence rates using population estimates from the U.S. Census Bureau.
Findings.
During 2010–2017, 6,072 TB cases occurred among children and adolescents; of these, 85% (5,175/6,072) occurred in the 50 U.S. states or the District of Columbia and 15% (897/6,072) in U.S.-Affiliated Islands. In U.S. States, 68% (3,520/5,175) cases occurred among U.S.-born persons overall, including 76% (2,977/3896) among children and 42% (543/1,279) among adolescents. The incidence rate among children and adolescents was 1.0 per 100,000 person-years during 2007–2017 and declined 47.8% (95% CI −51.4%, −44.1%) during this period. We observed disproportionately high TB rates among children and adolescents of all non-white racial/ethnic groups, those living in U.S.-Affiliated Islands, and children born in or with parents from TB-endemic countries.
Interpretations.
Overall, TB incidence among children and adolescents in the U.S. is low and steadily declining, but additional efforts are needed to eliminate stark disparities in incidence and mortality.
Funding.
Centers for Disease Control and Prevention
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Pubmed ID:31446052
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Pubmed Central ID:PMC8972148
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