Department of Global Health and Population, Center for Health Decision Science, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Division of TB Elimination, US Centers for Disease Control and Prevention, Atlanta, Georgia.
Int J Tuberc Lung Dis. 2018 Dec 1;22(12):1392-1403. doi: 10.5588/ijtld.17.0185.
Due to greater exposure to infection before migration, migrants moving to low-incidence settings can experience substantially higher tuberculosis (TB) rates than the native-born population. This review describes the impact of migration on TB epidemiology in the United States, and how the TB burden differs between US-born and non-US-born populations. The United States has a long history of receiving migrants from other parts of the world, and TB among non-US-born individuals now represents the majority of new TB cases. Based on an analysis of TB cases among individuals from the top 30 countries of origin in terms of non-US-born TB burden between 2003 and 2015, we describe how TB risks vary within the non-US-born population according to age, years since entry, entry year, and country of origin. Variation along each of these dimensions is associated with more than 10-fold differences in the risk of developing active TB, and this risk is also positively associated with TB incidence estimates for the country of origin and the composition of the migrant pool in the entry year. Approximately 87 000 lifetime TB cases are predicted for the non-US-born population resident in the United States in 2015, and 5800 lifetime cases for the population entering the United States in 2015.
由于在移民前接触感染的机会增加，移民到低发病率地区的人比土生土长的人口患结核病（TB）的比率要高得多。这篇综述描述了移民对美国结核病流行病学的影响，以及美国出生和非美国出生人群之间的结核病负担有何不同。美国有着接收来自世界其他地区移民的悠久历史，现在非美国出生的人当中的结核病代表了大多数新的结核病病例。根据 2003 年至 2015 年期间，非美国出生的结核病负担前 30 个原籍国的个体结核病病例分析，我们描述了根据年龄、入境年限、入境年份和原籍国，非美国出生人群中结核病风险如何变化。这些维度中的每一个的变化都与发生活动性结核病的风险相差 10 多倍有关，而且这种风险也与原籍国的结核病发病率估计和入境年份移民群体的组成呈正相关。根据预测，2015 年居住在美国的非美国出生人口将有大约 87000 例终身结核病病例，而 2015 年进入美国的人口将有 5800 例终身结核病病例。
