Talbot E A, Moore M, McCray E, Binkin N J
Division of Tuberculosis Elimination, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
JAMA. 2000 Dec 13;284(22):2894-900. doi: 10.1001/jama.284.22.2894.
Immigration is a major force sustaining the incidence of tuberculosis (TB) in the United States.
To describe trends and characteristics of foreign-born persons with TB and the implications for TB program planning and policy development.
DESIGN, SETTING, AND SUBJECTS: Descriptive analysis of US TB surveillance data from case reports submitted from 1993 to 1998.
Demographic and clinical characteristics of foreign-born persons with TB.
The number of TB cases among foreign-born persons increased 2.6%, from 7402 in 1993 to 7591 in 1998, and the proportion of US cases that were foreign-born increased from 29.8% to 41.6%. During 1993-1998, the TB case rate was 32.9 per 100000 population in foreign-born persons compared with 5.8 per 100000 in US-born persons. Six states reported 73.4% of foreign-born cases (California, New York, Texas, Florida, New Jersey, and Illinois). Approximately two thirds of these cases were originally from Mexico, the Philippines, Vietnam, India, China, Haiti, and South Korea. Among those for whom date of US entry was known, 51.5% arrived 5 years or less prior to the diagnosis of TB. Most were male and aged 25 to 44 years. During 1993-1996, the proportion receiving some portion of treatment under directly observed therapy increased from 27.3% to 59.1% and approximately 70% completed therapy in 12 months. The rate of primary resistance to isoniazid was 11.6% and to both isoniazid and rifampin was 1.7%. Conclusions As the United States moves toward the goal of TB elimination, success will depend increasingly on reducing the impact of TB in foreign-born persons. Continued efforts to tailor local TB control strategies to the foreign-born community and commitment to the global TB battle are essential.
移民是美国结核病（TB）发病率居高不下的一个主要因素。
描述出生在国外的结核病患者的趋势和特征，以及对结核病规划和政策制定的影响。
设计、地点和研究对象：对1993年至1998年提交的病例报告中的美国结核病监测数据进行描述性分析。
出生在国外的结核病患者的人口统计学和临床特征。
出生在国外的结核病患者数量增加了2.6%，从1993年的7402例增至1998年的7591例，在美国结核病病例中出生在国外者所占比例从29.8%增至41.6%。1993年至1998年期间，出生在国外者的结核病发病率为每10万人32.9例，而在美国出生者中这一发病率为每10万人5.8例。六个州报告了73.4%的出生在国外者的病例（加利福尼亚州、纽约州、得克萨斯州、佛罗里达州、新泽西州和伊利诺伊州）。这些病例中约三分之二最初来自墨西哥、菲律宾、越南、印度、中国、海地和韩国。在已知进入美国日期的患者中，51.5%在结核病诊断前5年或更短时间抵达美国。大多数为男性，年龄在25至44岁之间。1993年至1996年期间，接受直接观察治疗部分疗程的患者比例从27.3%增至59.1%，约70%的患者在12个月内完成治疗。对异烟肼的原发耐药率为11.6%，对异烟肼和利福平两者的原发耐药率为1.7%。结论随着美国朝着消除结核病的目标迈进，成功将越来越取决于减少出生在国外者中结核病的影响。继续努力使地方结核病控制策略适应出生在国外者群体，并致力于全球结核病防治斗争至关重要。
