Document Detail


Tuberculosis in indigenous peoples in the U.S., 2003-2008.
MedLine Citation:
PMID:  21886328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We examined trends and epidemiology of tuberculosis (TB) across racial/ethnic groups to better understand TB disparities in the United States, with particular focus on American Indians/Alaska Natives (AI/ANs) and Native Hawaiians/other Pacific Islanders (NH/PIs).
METHODS: We analyzed cases in the U.S. National Tuberculosis Surveillance System and calculated TB case rates among all racial/ethnic groups from 2003 to 2008. Socioeconomic and health indicators for counties in which TB cases were reported came from the Health Resources and Services Administration Area Resource File.
RESULTS: Among the 82,836 TB cases, 914 (1.1%) were in AI/ANs and 362 (0.4%) were in NH/PIs. In 2008, TB case rates for AI/ANs and NH/PIs were 5.9 and 14.7 per 100,000 population, respectively, rates that were more than five and 13 times greater than for non-Hispanic white people (1.1 per 100,000 population). From 2003 to 2008, AI/ANs had the largest percentage decline in TB case rates (-27.4%) for any racial/ethnic group, but NH/PIs had the smallest percentage decline (-3.5%). AI/ANs were more likely than other racial/ethnic groups to be homeless, excessively use alcohol, receive totally directly observed therapy, and come from counties with a greater proportion of people living in poverty and without health insurance. A greater proportion of NH/PIs had extrapulmonary disease and came from counties with a higher proportion of people with a high school diploma.
CONCLUSIONS: There is a need to develop flexible TB-control strategies that address the social determinants of health and that are tailored to the specific needs of AI/ANs and NH/PIs in the U.S.
Authors:
Emily Bloss; Timothy H Holtz; John Jereb; John T Redd; Laura Jean Podewils; James E Cheek; Eugene McCray
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Public health reports (Washington, D.C. : 1974)     Volume:  126     ISSN:  0033-3549     ISO Abbreviation:  Public Health Rep     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-09-02     Completed Date:  2011-11-02     Revised Date:  2012-09-28    
Medline Journal Info:
Nlm Unique ID:  9716844     Medline TA:  Public Health Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  677-89     Citation Subset:  AIM; IM    
Affiliation:
Centers for Disease Control and Prevention, Division of Tuberculosis Elimination, International Research and Programs Branch, Atlanta, GA, USA. dpu2@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Alaska / epidemiology,  ethnology
Antitubercular Agents / therapeutic use
Child
Child, Preschool
Female
Hawaii / epidemiology,  ethnology
Health Status Indicators
Humans
Indians, North American / statistics & numerical data
Inuits / statistics & numerical data
Male
Middle Aged
Oceanic Ancestry Group / statistics & numerical data
Population Surveillance
Risk Factors
Treatment Outcome
Tuberculosis / drug therapy,  epidemiology,  ethnology*
United States / epidemiology
Chemical
Reg. No./Substance:
0/Antitubercular Agents
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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