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Trends in death with tuberculosis during the AIDS era
M M Braun1, T R Coté, C S Rabkin
1Environmental Studies Section, National Cancer Institute, Bethesda, Md.
JAMA
|June 9, 1993
Summary
The acquired immunodeficiency syndrome (AIDS) epidemic significantly increased tuberculosis deaths in young adults (ages 20-49) in the US by 1990. Higher AIDS incidence states saw the largest rise in tuberculosis mortality for this age group.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- The acquired immunodeficiency syndrome (AIDS) epidemic emerged in the early 1980s, profoundly impacting public health.
- Tuberculosis (TB) has historically been a significant cause of mortality, with changing patterns observed over time.
Purpose of the Study:
- To analyze recent trends in tuberculosis mortality in the United States.
- To specifically examine the impact of the AIDS epidemic on tuberculosis deaths, particularly in younger adult populations.
Main Methods:
- Utilized National Center for Health Statistics mortality data from 1980-1990.
- Analyzed deaths with tuberculosis and/or AIDS as underlying or associated causes.
- Categorized states by AIDS incidence (high, medium, low) to compare TB death rates.
Main Results:
- A bimodal age distribution for TB deaths emerged, with a new peak in adults aged 20-49 coinciding with the AIDS epidemic.
- In 1990, over 54% of TB deaths in the 20-49 age group were in individuals with AIDS.
- Tuberculosis deaths increased significantly in younger adults, especially in high AIDS incidence states (362% rise).
Conclusions:
- The AIDS epidemic substantially increased tuberculosis mortality rates in younger adults through 1990.
- The study highlights the complex interplay between TB and AIDS, necessitating integrated prevention and treatment efforts.
- Further research is needed to differentiate deaths due to TB from deaths with TB in the context of AIDS.