Disparities in tuberculosis between Asian/Pacific Islanders and non-Hispanic Whites, United States, 1993-2006

The United States (US) National Tuberculosis Surveillance System (NTSS), including 50 states, District of Columbia, and New York City.

To examine disparities in characteristics and rates of Asian/Pacific Islander (API) and non-Hispanic White tuberculosis (TB) patients.

Descriptive analysis and logistic regression of selected 1993-2006 NTSS data. US Census Bureau Zip Code Tabulation Areas and geographic information system were used to compare API and non-Hispanic White TB patients by population density.

Of 253,299 TB cases, 19.8% were APIs and 23.2% were Whites; 94.2% APIs and 11.9% Whites were foreign-born. Factors that were most often associated with APIs were being female, age 15-24 years, extra-pulmonary TB, and drug resistance. APIs were less likely than Whites to be human immunodeficiency virus (HIV) positive, homeless, substance abusers, or on directly observed therapy. From 1993 to 2006, the API TB case rate declined by 42.9% vs. 66.6% in Whites (P < 0.01). Being foreign-born was the strongest risk factor for TB, regardless of population densities, but APIs were more likely to have TB than foreign-born Whites at lower population densities.

Disparities in TB exist among US APIs and non-Hispanic Whites. TB program officials should allocate programs appropriately for foreign-born APIs in lower population density areas.