21 Aug US Pediatric Tuberculosis Rates Higher in Children Born in Endemic Countries
MedicalResearch.com Interview with:
Tori Cowger, MPH
Ph.D Student | Population Health Sciences
Department of Epidemiology
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Globally, approximately one million cases of tuberculosis disease (TB) and 233,000 TB-related deaths occurred among children aged younger than 15 years during 2018. TB in children and adolescents is clinically and epidemiologically heterogeneous, making diagnosis, care, and prevention challenging. Understanding this heterogeneity can inform TB care and prevention efforts, and efforts to eliminate disparities in TB incidence and mortality in these groups.
In this study, we describe the epidemiology of TB among children and adolescents in the United States, and report TB incidence rates for US territories and freely associated states and by parental country of birth, which have not been previously described.
MedicalResearch.com: What are the main findings?
Response: Overall, we found that TB incidence among children and adolescents during 2007–17 was low – 1·0 case per 100 000 person-years – and decreased substantially (48%) during this period. However, these results were not uniform – TB burden and trends varied substantially across geographies and sociodemographic groups. We observed disproportionately high rates of TB among children and adolescents of all non-white racial or ethnic groups examined, children and adolescents living in US-affiliated islands, and children born in or with parents from TB-endemic countries.
MedicalResearch.com: What should readers take away from your report?
Response: Our results show that overall TB incidence among children and adolescents in the United States is low and steadily declining. However, we also observed wide-ranging and pervasive disparities by race or ethnicity, geography, and place of birth. These disparities probably reflect structural inequalities that give rise to disproportionate exposure, vulnerability to infection and disease, and unequal access to prompt diagnosis and treatment.
Our findings suggest that TB care and prevention strategies in the USA are succeeding in reducing overall TB burden among children and adolescents, but that more attention and possibly new approaches are needed to address the disparities in TB incidence and mortality in these age groups.
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