Department of Epidemiology, University of Washington, Seattle, WA.
Washington State Department of Health, TB Control Program, Seattle, WA.
Int J Tuberc Lung Dis. 2021 Jul 1;25(7):560-566. doi: 10.5588/ijtld.20.0823.
Progress towards TB elimination in the United States will require improved detection and treatment of latent TB infection among non-U.S.-born residents who remain at disproportionate risk of TB disease. To inform targeted testing efforts, we evaluated risk of TB disease among non-U.S.-born residents of Washington State, USA, by region of origin and time from U.S. entry. We conducted a retrospective cohort study among non-U.S.-born residents diagnosed with TB disease in Washington State from 2005 to 2014, for which country-specific population estimates were also available. The risk of TB disease among non-U.S.-born residents was estimated by time since U.S. entry, World Bank region of origin, and WHO TB incidence category. Risk of TB disease for non-U.S.-born residents was highest within the first year after U.S. entry. Among persons from countries with high TB incidence who had resided in the United States for more than 20 years, risk for TB remained elevated. Elevated risk of developing TB disease among individuals not born in the United States persisted long after U.S. entry, particularly among persons originating from certain regions and from high-burden countries. These findings contribute to evidence supporting a refinement of existing screening guidelines.
美国在结核病消除方面的进展将需要提高对非出生于美国的居民的潜伏性结核病感染的检测和治疗水平，因为他们仍然面临不成比例的结核病发病风险。为了指导有针对性的检测工作，我们评估了美国华盛顿州非出生于美国的居民的结核病发病风险，评估因素包括原籍地区和入境美国后的时间。我们对 2005 年至 2014 年期间在华盛顿州被诊断患有结核病的非出生于美国的居民进行了一项回顾性队列研究，其中还提供了针对特定国家的人口估计数据。通过入境美国后的时间、世界银行原籍地区和世界卫生组织结核病发病率类别来估计非出生于美国的居民的结核病发病风险。非出生于美国的居民的结核病发病风险在入境美国后的第一年最高。对于来自结核病发病率高的国家且在美国居住超过 20 年的人，结核病发病风险仍然很高。在美国入境后很长一段时间内，非出生于美国的个人患结核病的风险仍然很高，特别是来自某些地区和高负担国家的人。这些发现为支持完善现有的筛查指南提供了证据。
