June 20, 2011
The current study examined TB incidence rates and characteristics of TB patients in 48 large U.S. cities.
Data from CDC's National Tuberculosis Surveillance System were used to categorize the cities annually from 2000 to 2007 as reporting decreasing or nondecreasing rates with Joinpoint analysis. Patients' demographic, clinical and treatment characteristics were compared using bivariate and multivariate analyses.
The 42,448 TB patients in 48 cities accounted for 36 percent of all U.S. TB patients; 15 percent of the U.S. population resided in these cities. "The average TB incidence rate in the 48 cities (12.1 per 100,000) was higher than that in the U.S. excluding the cities (3.8 per 100,000) but decreased at a faster rate. Nineteen cities had decreasing rates; 29 cities had nondecreasing rates," the authors reported. Decreasing and nondecreasing rate cities could not be distinguished conclusively from patient characteristics.
Large cities comprise a significant TB burden in the United States, the authors concluded. "More than half (60 percent) of the selected cities did not show decreasing TB incidence rates. Studies of city-level variations in migration, socioeconomic status, and resources are needed to improve urban TB control," they added.