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Extrapulmonary tuberculosis in the United States.

H L Rieder1, D E Snider, G M Cauthen

  • 1Division of Tuberculosis Control, Centers for Disease Control, Atlanta, GA 30333.

The American Review of Respiratory Disease
|February 1, 1990
PubMed
Summary

Extrapulmonary tuberculosis (TB) cases declined slower than pulmonary TB cases between 1963-1986. Demographic factors like age, race, and origin significantly influenced extrapulmonary TB prevalence, with reasons yet unexplained.

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Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Diseases

Background:

  • Tuberculosis (TB) incidence has historically varied by site (pulmonary vs. extrapulmonary) and demographic group.
  • Understanding trends in extrapulmonary TB is crucial for targeted public health interventions.
  • Significant demographic shifts in TB cases may influence disease patterns.

Purpose of the Study:

  • To analyze trends in pulmonary and extrapulmonary tuberculosis (TB) in the U.S. from 1963 to 1986.
  • To identify demographic factors associated with extrapulmonary TB.
  • To explore potential reasons for differing TB trends.

Main Methods:

  • Analysis of reported tuberculosis cases in the United States between 1963 and 1986.
  • Calculation of annual percentage decline for pulmonary and extrapulmonary TB.

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  • Statistical adjustment for demographic variables (age, race/ethnicity, sex, country of birth) to assess their impact on extrapulmonary TB proportion.

    • Main Results:

    • Pulmonary TB cases declined significantly (5.0% annually), while extrapulmonary TB cases declined minimally (0.9% annually).
    • In 1986, extrapulmonary TB constituted 17.5% of all cases, disproportionately affecting racial/ethnic minorities and the foreign-born (71.2%).
    • Extrapulmonary TB was most common in children, decreasing with age, and higher in Black, Asian, American Indian, female, and foreign-born populations compared to non-Hispanic whites and US-born individuals.

    Conclusions:

    • The slower decline in extrapulmonary TB may be linked to evolving demographic characteristics of the patient population.
    • Significant variations in susceptibility to extrapulmonary TB exist across different demographic groups.
    • Further research is needed to elucidate the underlying reasons for these observed demographic differences in extrapulmonary TB.