Abstract
AbstractApproximately 90% of US tuberculosis (TB) cases among non–US-born persons are attributable to progression of latent TB infection to TB disease. Using survival analysis, we investigated if birthplace is associated with time of progression to TB disease among non–US-born persons. We derived a Cox regression model comparing differences in time to TB diagnosis after US entry among 19 global birth regions, adjusting for sex, birth year, and age at diagnosis. Compared with persons from Western Europe, the adjusted hazard rate of developing TB was significantly higher (p ≤0.05) for persons from all other regions, except North America and Northern Europe, and highest among persons from Middle Africa (adjusted hazard ratio = 7.0; 95% confidence interval: 6.5–7.4). Time to TB diagnosis among non–US-born persons therefore varied by birth region, which represents an important prognostic indicator for progression to TB disease.
Publisher
Cold Spring Harbor Laboratory
Reference34 articles.
1. Centers for Disease Control and Prevention (CDC)/Division of Tuberculosis Elimination. Reported tuberculosis in the United States, 2018 [Internet]. Atlanta, GA: US Department of Health and Human Services, CDC; 2019 [cited 2020 February 21]. https://www.cdc.gov/tb/statistics/reports/2018/default.htm
2. Centers for Disease Control and Prevention (CDC)/Division of Tuberculosis Elimination. Latent tuberculosis infection: a guide for primary health care providers [Internet]. Atlanta, GA: US Department of Health and Human Services, CDC; 2013 [cited 2020 February 21]. https://www.cdc.gov/tb/publications/ltbi/pdf/targetedltbi.pdf
3. A Field-Validated Approach Using Surveillance and Genotyping Data to Estimate Tuberculosis Attributable to Recent Transmission in the United States
4. Recent Transmission of Tuberculosis — United States, 2011–2014
5. Tuberculosis— United States, 2018;MMWR Morb Mortal Wkly Rep,2019