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Black DA, McBrien SW, Gersh J, Ghassemieh B, Narita M, Pecha MJ, Tan Y, Horne DJ. TB risk by time since U.S. entry among non-U.S.-born residents of Washington State, USA. Int J Tuberc Lung Dis 2021; 25:560-566. [PMID: 34183101 DOI: 10.5588/ijtld.20.0823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: 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.METHODS: 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.RESULTS: 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.CONCLUSION: 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.
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Affiliation(s)
- D A Black
- Department of Epidemiology, University of Washington, Seattle, WA
| | - S W McBrien
- Washington State Department of Health, TB Control Program, Seattle, WA
| | - J Gersh
- Department of Medicine, University of Washington, Seattle, WA
| | - B Ghassemieh
- Department of Medicine, University of Washington, Seattle, WA
| | - M Narita
- Department of Medicine, University of Washington, Seattle, WA, Public Health - Seattle & King County, TB Control Program, Seattle, WA
| | - M J Pecha
- Washington State Department of Health, TB Control Program, Seattle, WA
| | - Y Tan
- Department of Electrical & Computer Engineering, University of Washington, Seattle, WA, USA
| | - D J Horne
- Department of Medicine, University of Washington, Seattle, WA, Department of Global Health, University of Washington, Seattle, WA, USA
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