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Epidemiología de la tuberculosis en los Estados Unidos, 1985 a 1992
M F Cantwell1, D E Snider, G M Cauthen
1Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30333.
JAMA
|August 17, 1994
Resumen
Los casos de tuberculosis (TB) aumentaron entre 1985 y 1992, principalmente entre las minorías, los adultos jóvenes y los nacidos en el extranjero. La infección por el virus de la inmunodeficiencia humana (VIH) tuvo un impacto significativo en la morbilidad por tuberculosis en grupos demográficos específicos, lo que indica un aumento en las tasas de transmisión.
Área de la Ciencia:
- Salud Pública La salud pública.
- Epidemiología La epidemiología.
- Enfermedad Infecciosa Enfermedad Infecciosa.
Sus antecedentes:
- Los Estados Unidos experimentaron un notable aumento en la morbilidad por tuberculosis (TB) entre 1985 y 1992.
- Comprender la distribución demográfica y los orígenes de este aumento de la TB es crucial para las intervenciones de salud pública.
Objetivo del estudio:
- Investigar la distribución y las fuentes primarias que contribuyen al aumento de los casos de tuberculosis en los EE.UU. durante 1985-1992.
Principales métodos:
- Análisis de los datos de vigilancia de la tuberculosis informados a los Centros para el Control y la Prevención de Enfermedades (CDC) de 1980 a 1992.
- Examen de los cambios en los casos reportados de TB por sexo, raza / etnia, edad, lugar de nacimiento, lugar de la enfermedad, ubicación y estado socioeconómico.
- Estimación del exceso de casos de TB mediante la comparación de los datos observados con las tendencias extrapoladas de 1980-1984.
Principales resultados:
- Los aumentos en los casos de tuberculosis se concentraron entre las minorías raciales / étnicas, las personas de 25 a 44 años, los hombres y la población nacida en el extranjero.
- Los individuos nacidos en el extranjero representaron el 60% del aumento total de casos de TB en los Estados Unidos (1986-1992).
- La infección por el virus de la inmunodeficiencia humana (VIH) fue un factor significativo, que impactó particularmente en la morbilidad por tuberculosis entre las poblaciones blancas, negras, masculinas y de 25 a 44 años. Un aumento del 36% en los casos de TB entre los niños menores de 4 años sugiere un aumento de la transmisión.
Conclusiones:
- Múltiples factores contribuyeron al aumento de los casos de tuberculosis, incluida la inmigración y la coinfección por el VIH.
- Se recomienda una mayor evaluación de la efectividad de la detección de la tuberculosis en los inmigrantes.
- Es necesario ampliar el cribado de la tuberculosis y el VIH entre las poblaciones de alto riesgo.
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