MMWR Morb Mortal Wkly Rep. 2020 Mar 20;69(11):286-289. doi: 10.15585/mmwr.mm6911a3.
Since 1989, the United States has pursued a goal of eliminating tuberculosis (TB) through a strategy of rapidly identifying and treating cases and evaluating exposed contacts to limit secondary cases resulting from recent TB transmission (1). This strategy has been highly effective in reducing U.S. TB incidence (2), but the pace of decline has significantly slowed in recent years (2.2% average annual decline during 2012-2017 compared with 6.7% during 2007-2012) (3). For this report, provisional 2019 data reported to CDC's National Tuberculosis Surveillance System were analyzed to determine TB incidence overall and for selected subpopulations and these results were compared with those from previous years. During 2019, a total of 8,920 new cases were provisionally reported in the United States, representing a 1.1% decrease from 2018.* TB incidence decreased to 2.7 cases per 100,000 persons, a 1.6% decrease from 2018. Non-U.S.-born persons had a TB rate 15.5 times greater than the rate among U.S.-born persons. The U.S. TB case count and rate are the lowest ever reported, but the pace of decline remains slow. In recent years, approximately 80% of U.S. TB cases have been attributed to reactivation of latent TB infection (LTBI) acquired years in the past, often outside the United States (2). An expanded TB elimination strategy for this new decade should leverage existing health care resources, including primary care providers, to identify and treat persons with LTBI, without diverting public health resources from the continued need to limit TB transmission within the United States. Partnerships with health care providers, including private providers, are essential for this strategy's success.
自 1989 年以来，美国通过快速识别和治疗病例以及评估接触者来限制近期结核病传播引起的继发性病例的策略，追求消除结核病（TB）的目标（1）。该策略在降低美国结核病发病率方面非常有效（2），但近年来下降速度明显放缓（2012-2017 年平均每年下降 2.2%，而 2007-2012 年下降 6.7%）（3）。本报告分析了向疾病预防控制中心国家结核病监测系统报告的 2019 年临时数据，以确定总体结核病发病率以及选定的亚人群的发病率，并将这些结果与前几年进行比较。2019 年，美国共报告了 8920 例新发病例，比 2018 年减少了 1.1%。*结核病发病率降至每 10 万人 2.7 例，比 2018 年下降 1.6%。非美国出生的人结核病发病率是美国出生者的 15.5 倍。美国的结核病病例数和发病率是有记录以来的最低水平，但下降速度仍然缓慢。近年来，美国约 80%的结核病病例归因于过去多年潜伏性结核感染（LTBI）的再激活，这些感染通常发生在美国境外（2）。新十年的扩大结核病消除策略应利用现有的医疗保健资源，包括初级保健提供者，来识别和治疗 LTBI 患者，而不会从继续限制美国境内结核病传播的需要中转移公共卫生资源。与医疗保健提供者（包括私人提供者）建立伙伴关系对于该策略的成功至关重要。
