Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Int J Tuberc Lung Dis. 2019 Jul 1;23(7):797-804. doi: 10.5588/ijtld.18.0757.
After 20 years of steady decline, the pace of decline of tuberculosis (TB) incidence in the United States has slowed. Trends in TB incidence rates and case counts since 1993 were assessed using national US surveillance data. Patient characteristics reported during 2014-2017 were compared with those for 2010-2013. TB rates and case counts slowed to an annual decline of respectively 2.2% (95%CI -3.4 to -1.0) and 1.5% (95%CI -2.7 to -0.3) since 2012, with decreases among US-born persons and no change among non-US-born persons. Overall, persons with TB diagnosed during 2014-2017 were older, more likely to have combined pulmonary and extra-pulmonary disease than extra-pulmonary disease alone, more likely to be of non-White race, and less likely to have human immunodeficiency virus infection, or cavitary pulmonary disease. During 2014-2017, non-US-born persons with TB were more likely to have diabetes mellitus, while the US-born were more likely to have smear-positive TB and use non-injecting drugs. Changes in epidemiologic trends are likely to affect TB incidence in the coming decades. The Centers for Disease Control and Prevention has called for increased attention to TB prevention through the detection and treatment of latent tuberculous infection.
经过 20 年的稳步下降，美国结核病（TB）发病率的下降速度已经放缓。利用美国全国监测数据评估了自 1993 年以来结核病发病率和病例数的趋势。比较了 2014-2017 年报告的患者特征与 2010-2013 年的特征。自 2012 年以来，TB 发病率和病例数分别以每年 2.2%（95%CI-3.4 至-1.0）和 1.5%（95%CI-2.7 至-0.3）的速度放缓，美国出生者的下降速度较慢，而非美国出生者没有变化。总体而言，2014-2017 年诊断出的结核病患者年龄更大，合并肺外和肺内疾病的可能性大于单纯肺外疾病，更可能是非白人种族，感染人类免疫缺陷病毒或有空洞性肺病的可能性较小。2014-2017 年，患有结核病的非美国出生者更有可能患有糖尿病，而美国出生者更有可能患有痰涂片阳性结核病和使用非注射药物。流行病学趋势的变化可能会影响未来几十年的结核病发病率。疾病控制和预防中心呼吁通过检测和治疗潜伏性结核感染，更加关注结核病预防。
