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Published on: July 28, 2023
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Changes in tuberculosis epidemiology, United States, 1993-2017
L R Armstrong1, C A Winston1, B Stewart1
1Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Summary
The decline in tuberculosis (TB) incidence has slowed in the US since 2012. Recent TB cases show shifts in patient demographics and risk factors, highlighting evolving prevention needs.
Area of Science:
- Epidemiology
- Public Health
Background:
- Tuberculosis (TB) incidence in the US experienced a steady decline for two decades.
- Recent data indicates a significant slowdown in this decline since 2012.
Purpose of the Study:
- To analyze trends in TB incidence rates and case counts in the US since 1993.
- To compare patient characteristics of TB cases between 2010-2013 and 2014-2017.
Main Methods:
- Utilized national US surveillance data to assess TB incidence trends.
- Compared demographic and clinical characteristics of TB patients diagnosed in 2014-2017 versus 2010-2013.
Main Results:
- TB rates and case counts slowed their decline to 2.2% and 1.5% annually since 2012, respectively.
- No change in incidence was observed among non-US-born individuals, while US-born incidence decreased.
- Patients diagnosed in 2014-2017 were older, more likely to be non-White, and had combined pulmonary/extra-pulmonary disease compared to earlier periods. Non-US-born individuals had higher rates of diabetes, while US-born individuals had higher rates of smear-positive TB and non-injecting drug use.
Conclusions:
- Shifting epidemiologic trends in TB incidence are anticipated to impact future public health strategies.
- Increased focus on TB prevention, including latent TB infection detection and treatment, is recommended by the CDC.
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