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Decline in foreign-born tuberculosis cases seen in the United States

Researchers in this study reported a decrease in the number of tuberculosis cases in the United States originating from recent and non-recent foreign-born entrants to the country, according to recent research.

“Overall, we found that during 2007–2011, there was an abrupt decline in reported [tuberculosis] TB cases among foreign-born persons living in the United States, and this decline was evident among both recent and non-recent entrants,” Brian J. Baker, MD, from the Division of Tuberculosis Elimination at the U.S. Centers for Disease Control and Prevention in Atlanta, Georgia, and colleagues wrote in their study. “Among recent entrants, the decline was associated with a decrease in TB case rate as well as a decrease in population, but this varied by country of origin. In addition, non-recent entrants also substantially contributed to the decline, exclusively as a result of a decreasing TB case rate.”

Baker and colleagues analyzed data from the U.S. National Tuberculosis Surveillance System and the American Community Survey to determine population estimates, tuberculosis case counts and tuberculosis case rates by year and country of origin, according to the abstract. They investigated the change in foreign-born population size based on immigration and emigration, change in distribution of country of origin and changes in case rates for tuberculosis.

The researchers found a 39.5% decline (1,013 cases) in tuberculosis cases from recent foreign-born entrants who entered the country within 3 years beginning in 2007 (p < 0.05) and ending in 2011 (p < 0.05), according to the abstract. The decline varied by country: there was an 80.7% decline in cases among recent entrants from Mexico, which was attributed to a decrease in population, while 95.5% to 100% of the decline among recent entrants from countries such as China, Indian, Vietnam and the Philippines were from a decrease in the tuberculosis case rate.

Regarding non-recent entrants, there was an 8.9% decline (443 cases) that was attributable to a decrease in the tuberculosis case rate, according to the abstract.

“Strategies that impact both recent and non-recent entrants (e.g., investment in overseas TB control) as well as those that focus on non-recent entrants (e.g., targeted testing of high-risk subpopulations among non-recent entrants) will be necessary to achieve further declines in TB morbidity among foreign-born persons,” Baker and colleagues wrote. – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.