Decline in Tuberculosis among Mexico-Born Persons in the United States, 2000–2010

Abstract

Background In 2010, Mexico was the most common (22.9%) country of origin for foreign-born persons with tuberculosis in the United States, and overall trends in tuberculosis morbidity are substantially influenced by the Mexico-born population. Objectives To determine the risk of tuberculosis disease among Mexico-born persons living in the United States. Methods Using data from the U.S. National Tuberculosis Surveillance System and the American Community Survey, we examined tuberculosis case counts and case rates stratified by years since entry into the United States and geographic proximity to the United States–Mexico border. We calculated trends in case rates over time measured by average annual percent change. Results The total tuberculosis case count (−14.5%) and annual tuberculosis case rate (average annual percent change −5.1%) declined among Mexico-born persons. Among those diagnosed with tuberculosis less than 1 year since entry into the United States (newly arrived persons), there was a decrease in tuberculosis cases (−60.4%), no change in tuberculosis case rate (average annual percent change of 0.0%), and a decrease in population (−60.7%). Among those living in the United States for more than 5 years (non-recently arrived persons), there was an increase in tuberculosis cases (+3.4%), a decrease in tuberculosis case rate (average annual percent change of −4.9%), and an increase in population (+62.7%). In 2010, 66.7% of Mexico-born cases were among non–recently arrived persons, compared with 51.1% in 2000. Although border states reported the highest proportions (>15%) of tuberculosis cases that were Mexico-born, the highest Mexico-born–specific tuberculosis case rates (>20/100,000 population) were in states in the eastern and southeastern regions of the United States. Conclusions The decline in tuberculosis morbidity among Mexico-born persons may be attributed to fewer newly arrived persons from Mexico and lower tuberculosis case rates among non–recently arrived Mexico-born persons. The extent of the decline was dampened by an unchanged tuberculosis case rate among newly arrived persons from Mexico and a large increase in the non–recently arrived Mexico-born population. If current trends continue, tuberculosis morbidity among Mexico-born persons will be increasingly driven by those who have been living in the United States for more than 5 years.

Mind the gap: TB trends in the USA and the UK, 2000–2011

“…1527 But it may also reflect diminishing TB burdens in key US immigrant-originating countries. 132 In the UK, TB screening practices during this period, in contrast, was largely limited to chest X-ray-based screening of selected migrants at two major airports, as well as screening of a smaller number of refugees and asylum seekers already in the country. The increases in cases among UK recent arrivals may thus represent a large number that could have been prevented through a more effective prearrival screening programme.…”

Latent Tuberculosis Infection among Foreign-Born Persons: A Prioritized Approach

“…We thank Dr. Griffith for his insightful commentary (1) on our recent analysis (2) and would like to address and expand on his remarks. More than two-thirds of all tuberculosis cases in the United States are among foreign-born persons, and it is estimated that most tuberculosis cases among these individuals are a result of the reactivation of latent tuberculosis infection.…”

Testing for Latent Tuberculosis. Applying the Best of Intentions

“…The public health consequences of these socioeconomic forces has been to make long-term U.S. immigrant residents from Mexico a more important target for tuberculosis control efforts, specifically latent infection diagnosis and treatment (2,5).…”

“…In 2010, 66.7% of Mexico-born cases were among non-recently arrived persons (compared with 51% in 2000). "If current trends continue, TB morbidity among Mexico-born persons in the United States will be increasingly driven by the non-recently arrived population" (5).…”

“…The study by Baker and colleagues persuasively argues in favor of changing the current guidelines for targeting latent infection screening and treatment in foreign-born persons (5). Perhaps that change has already been adopted in the forthcoming new latent infection guidelines.…”