Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1998 Jul;88(7):1059–1063. doi: 10.2105/ajph.88.7.1059

The fall after the rise: Tuberculosis in the United States, 1991 through 1994.

M T McKenna 1, E McCray 1, J L Jones 1, I M Onorato 1, K G Castro 1
PMCID: PMC1508272  PMID: 9663154

Abstract

OBJECTIVES: Factors associated with decreases in tuberculosis cases observed in the United States in 1993 and 1994 were analyzed. METHODS: Changes in case counts reported to the national surveillance system were evaluated by dividing the number of incident cases of TB reported in 1993 and 1994 by the number of cases reported in 1991 and 1992 and stratifying these ratios by demographic factors, AIDS incidence, and changes in program performance. RESULTS: Case counts decreased from 52,956 in 1991 and 1992 to 49,605 in 1993 and 1994 (case count ratio = 0.94, 95% confidence interval [CI] = 0.93, 0.95). The decrease, confined to US-born patients, was generally associated with AIDS incidence and improvements in completion of therapy, conversion of sputum, and increases in the number of contacts identified per case. CONCLUSIONS: Recent TB epidemiology patterns suggest that improvements in treatment and control activities have contributed to the reversal in the resurgence of this disease in US-born persons. Continued success in preventing the occurrence of active TB will require sustained efforts to ensure appropriate treatment of cases.

Full text

PDF
1059

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alland D., Kalkut G. E., Moss A. R., McAdam R. A., Hahn J. A., Bosworth W., Drucker E., Bloom B. R. Transmission of tuberculosis in New York City. An analysis by DNA fingerprinting and conventional epidemiologic methods. N Engl J Med. 1994 Jun 16;330(24):1710–1716. doi: 10.1056/NEJM199406163302403. [DOI] [PubMed] [Google Scholar]
  2. Binkin N. J., Zuber P. L., Wells C. D., Tipple M. A., Castro K. G. Overseas screening for tuberculosis in immigrants and refugees to the United States: current status. Clin Infect Dis. 1996 Dec;23(6):1226–1232. doi: 10.1093/clinids/23.6.1226. [DOI] [PubMed] [Google Scholar]
  3. Bloch A. B., Onorato I. M., Ihle W. W., Hadler J. L., Hayden C. H., Snider D. E., Jr The need for epidemic intelligence. Public Health Rep. 1996 Jan-Feb;111(1):26–33. [PMC free article] [PubMed] [Google Scholar]
  4. Blumberg H. M., Watkins D. L., Berschling J. D., Antle A., Moore P., White N., Hunter M., Green B., Ray S. M., McGowan J. E., Jr Preventing the nosocomial transmission of tuberculosis. Ann Intern Med. 1995 May 1;122(9):658–663. doi: 10.7326/0003-4819-122-9-199505010-00003. [DOI] [PubMed] [Google Scholar]
  5. Buehler J. W., De Cock K. M., Brunet J. B. Surveillance definitions for AIDS. AIDS. 1993;7 (Suppl 1):S73–S81. [PubMed] [Google Scholar]
  6. Burwen D. R., Bloch A. B., Griffin L. D., Ciesielski C. A., Stern H. A., Onorato I. M. National trends in the concurrence of tuberculosis and acquired immunodeficiency syndrome. Arch Intern Med. 1995 Jun 26;155(12):1281–1286. [PubMed] [Google Scholar]
  7. Chaulk C. P., Moore-Rice K., Rizzo R., Chaisson R. E. Eleven years of community-based directly observed therapy for tuberculosis. JAMA. 1995 Sep 27;274(12):945–951. [PubMed] [Google Scholar]
  8. Daley C. L., Small P. M., Schecter G. F., Schoolnik G. K., McAdam R. A., Jacobs W. R., Jr, Hopewell P. C. An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus. An analysis using restriction-fragment-length polymorphisms. N Engl J Med. 1992 Jan 23;326(4):231–235. doi: 10.1056/NEJM199201233260404. [DOI] [PubMed] [Google Scholar]
  9. Driver C. R., Luallen J. J., Good W. E., Valway S. E., Frieden T. R., Onorato I. M. Tuberculosis in children younger than five years old: New York City. Pediatr Infect Dis J. 1995 Feb;14(2):112–117. doi: 10.1097/00006454-199502000-00006. [DOI] [PubMed] [Google Scholar]
  10. Fridkin S. K., Manangan L., Bolyard E., Jarvis W. R. SHEA-CDC TB survey, Part I: Status of TB infection control programs at member hospitals, 1989-1992. Society for Healthcare Epidemiology of America. Infect Control Hosp Epidemiol. 1995 Mar;16(3):129–134. doi: 10.1086/647073. [DOI] [PubMed] [Google Scholar]
  11. Frieden T. R., Fujiwara P. I., Washko R. M., Hamburg M. A. Tuberculosis in New York City--turning the tide. N Engl J Med. 1995 Jul 27;333(4):229–233. doi: 10.1056/NEJM199507273330406. [DOI] [PubMed] [Google Scholar]
  12. Frieden T. R., Sherman L. F., Maw K. L., Fujiwara P. I., Crawford J. T., Nivin B., Sharp V., Hewlett D., Jr, Brudney K., Alland D. A multi-institutional outbreak of highly drug-resistant tuberculosis: epidemiology and clinical outcomes. JAMA. 1996 Oct 16;276(15):1229–1235. [PubMed] [Google Scholar]
  13. Jarvis W. R. Nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis. Res Microbiol. 1993 Feb;144(2):117–122. doi: 10.1016/0923-2508(93)90025-w. [DOI] [PubMed] [Google Scholar]
  14. Mangtani P., Jolley D. J., Watson J. M., Rodrigues L. C. Socioeconomic deprivation and notification rates for tuberculosis in London during 1982-91. BMJ. 1995 Apr 15;310(6985):963–966. doi: 10.1136/bmj.310.6985.963. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Poole C. Ecologic analysis as outlook and method. Am J Public Health. 1994 May;84(5):715–716. doi: 10.2105/ajph.84.5.715. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Reichman L. B. How to ensure the continued resurgence of tuberculosis. Lancet. 1996 Jan 20;347(8995):175–177. doi: 10.1016/s0140-6736(96)90348-7. [DOI] [PubMed] [Google Scholar]
  17. Small P. M., Hopewell P. C., Singh S. P., Paz A., Parsonnet J., Ruston D. C., Schecter G. F., Daley C. L., Schoolnik G. K. The epidemiology of tuberculosis in San Francisco. A population-based study using conventional and molecular methods. N Engl J Med. 1994 Jun 16;330(24):1703–1709. doi: 10.1056/NEJM199406163302402. [DOI] [PubMed] [Google Scholar]
  18. Starke J. R., Jacobs R. F., Jereb J. Resurgence of tuberculosis in children. J Pediatr. 1992 Jun;120(6):839–855. doi: 10.1016/s0022-3476(05)81949-3. [DOI] [PubMed] [Google Scholar]
  19. Van Dis F. J., Keilson L. M., Rundell C. A., Rawstron M. W. Direct measurement of serum low-density lipoprotein cholesterol in patients with acute myocardial infarction on admission to the emergency room. Am J Cardiol. 1996 Jun 1;77(14):1232–1234. doi: 10.1016/s0002-9149(96)00170-1. [DOI] [PubMed] [Google Scholar]
  20. Weis S. E., Slocum P. C., Blais F. X., King B., Nunn M., Matney G. B., Gomez E., Foresman B. H. The effect of directly observed therapy on the rates of drug resistance and relapse in tuberculosis. N Engl J Med. 1994 Apr 28;330(17):1179–1184. doi: 10.1056/NEJM199404283301702. [DOI] [PubMed] [Google Scholar]
  21. Wenger P. N., Otten J., Breeden A., Orfas D., Beck-Sague C. M., Jarvis W. R. Control of nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis among healthcare workers and HIV-infected patients. Lancet. 1995 Jan 28;345(8944):235–240. doi: 10.1016/s0140-6736(95)90228-7. [DOI] [PubMed] [Google Scholar]
  22. Zuber P. L., McKenna M. T., Binkin N. J., Onorato I. M., Castro K. G. Long-term risk of tuberculosis among foreign-born persons in the United States. JAMA. 1997 Jul 23;278(4):304–307. [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES