TABLE 1.
CHARACTERISTICS OF INITIAL TUBERCULOSIS EPISODE AMONG PATIENTS DIAGNOSED WITH RECURRENT TUBERCULOSIS AT LEAST 12 MONTHS AFTER TREATMENT COMPLETION, CONTRASTED TO COMPARISON GROUP PRESUMED TO HAVE SINGLE EPISODE ONLY, STRATIFIED BY PATIENT BIRTH ORIGIN – UNITED STATES, 1993–2006*
| US-born patients | Foreign-born patients | ||||||
|---|---|---|---|---|---|---|---|
|
| |||||||
| Characteristic of initial TB episode† | Later recurrent TB No. (%) |
Single episode only No. (%) |
P value‡ | Later recurrent TB No. (%) |
Single episode only No. (%) |
P value‡ | |
| n=632 | n=78 498 | n=211 | n=63 723 | ||||
| Age | 0–14 | 7 (1.1) | 8770 (11.2) | <0.001 | 2 (1.0) | 3042 (4.8) | <0.001 |
| 15–24 | 24 (3.8) | 4752 (6.1) | 20 (9.5) | 9981 (15.7) | |||
| 25–44 | 314 (49.7) | 23 729 (30.2) | 108 (51.2) | 26 851 (42.1) | |||
| 45–64 | 201 (31.8) | 23 577 (30.0) | 61 (28.9) | 14 846 (23.3) | |||
| ≥65 | 86 (13.6) | 17 670 (22.5) | 20 (9.5) | 9003 (14.1) | |||
| Sex | Female | 164 (25.9) | 28 393 (36.2) | <0.001 | 71 (33.7) | 26 959 (42.3) | 0.04 |
| Male | 468 (74.1) | 50 101 (63.8) | 140 (66.4) | 36 760 (57.7) | |||
| Race/ethnicity | Non-Hisp. white | 207 (32.8) | 28 369 (36.1) | <0.001 | 12 (5.7) | 4124 (6.5) | 0.25 |
| Non-Hisp. black | 359 (56.8) | 35 917 (45.8) | 26 (12.3) | 7807 (12.3) | |||
| Hispanic | 41 (6.5) | 10 495 (13.4) | 97 (46.0) | 23 680 (37.2) | |||
| Asian | 2 (0.3) | 1035 (1.3) | 76 (36.0) | 27 509 (43.2) | |||
| American Indian | 23 (3.6) | 1812 (2.3) | 0 (0) | 37 (0.1) | |||
| Native Hawaiian | 0 (0) | 328 (0.4) | 0 (0) | 112 (0.2) | |||
| Multiple | 0 (0) | 40 (0.1) | 0 (0) | 49 (0.1) | |||
| Substance use§ | No | 261 (41.3) | 50 613 (64.5) | <0.001 | 162 (76.8) | 54 078 (84.9) | 0.003 |
| Yes | 281 (44.5) | 18 561 (23.7) | 25 (11.9) | 4313 (6.8) | |||
| Unknown | 90 (14.2) | 9324 (11.9) | 24 (11.4) | 5332 (8.4) | |||
| Homeless in past 12 months | No | 497 (78.6) | 68 425 (87.2) | <0.001 | 200 (94.8) | 59 760 (93.8) | 0.75 |
| Yes | 97 (15.4) | 6146 (7.8) | 3 (1.4) | 1370 (2.1) | |||
| Unknown | 38 (6.0) | 3927 (5.0) | 8 (3.8) | 2593 (4.1) | |||
| Correctional facility resident at diagnosis | No | 598 (94.6) | 74 395 (94.8) | 0.12 | 205 (97.2) | 62 562 (98.2) | 0.48 |
| Yes | 24 (3.8) | 3430 (4.4) | 5 (2.4) | 886 (1.4) | |||
| Employment | Employed | 225 (35.6) | 25 121 (32.0) | 0.02 | 107 (50.7) | 30 758 (48.3) | 0.15 |
| Unemployed | 323 (51.0) | 44 482 (56.7) | 79 (37.4) | 27 302 (42.8) | |||
| Unknown | 84 (13.2) | 8895 (11.3) | 25 (11.9) | 5663 (8.9) | |||
| HIV | Not positive¶ | 540 (85.4) | 71 484 (91.1) | <0.001 | 187 (88.6) | 60 972 (95.7) | <0.001 |
| Positive | 92 (14.6) | 7014 (8.9) | 24 (11.4) | 2751 (4.3) | |||
| Anatomic site of disease | Extrapulmonary | 41 (6.5) | 11 672 (14.9) | <0.001 | 37 (17.5) | 13 632 (21.4) | 0.52 |
| Pulmonary | 554 (87.7) | 62 214 (79.3) | 163 (77.3) | 46 338 (72.7) | |||
| Both | 37 (5.9) | 4592 (5.8) | 11 (5.2) | 3745 (5.9) | |||
| Acid-fast bacilli smear result (any site) | Negative | 195 (30.9) | 34 580 (44.1) | <0.001 | 85 (40.3) | 33 452 (52.5) | <0.001 |
| Positive | 414 (65.5) | 36 828 (46.9) | 122 (57.8) | 27 239 (42.7) | |||
| Unknown | 23 (3.6) | 7090 (9.0) | 4 (1.9) | 3032 (4.8) | |||
| Culture result (any site) | Negative | 40 (6.3) | 13 566 (17.3) | <0.001 | 28 (13.3) | 12 441 (19.5) | 0.005 |
| Positive | 581 (91.9) | 58 749 (74.8) | 180 (85.3) | 48 503 (76.1) | |||
| Unknown | 11 (1.7) | 6183 (7.9) | 3 (1.4) | 2779 (4.4) | |||
| Cavity visible on chest radiograph** | No | 326 (57.0) | 43 632 (68.7) | <0.001 | 116 (69.1) | 35 125 (72.7) | 0.54 |
| Yes | 223 (39.0) | 17 700 (27.9) | 49 (29.2) | 12 279 (25.4) | |||
| Unknown | 23 (4.0) | 2144 (3.4) | |||||
| Documented sputum culture conversion†† | Yes | 453 (88.1) | 35 933 (81.9) | 0.001 | 116 (80.0) | 29 748 (84.6) | 0.29 |
| No | 55 (10.7) | 6896 (15.7) | 26 (17.9) | 4755 (13.5) | |||
| Unknown | 6 (1.2) | 1040 (2.2) | 3 (2.1) | 655 (1.9) | |||
| Initial drug regimen | Standard 4-drug | 445 (70.4) | 50 372 (64.2) | 0.005 | 177 (83.9) | 52 007 (81.6) | 0.14 |
| INH and RIF only | 29 (4.6) | 4073 (5.2) | 1 (0.5) | 1690 (2.7) | |||
| Other | 158 (25.0) | 24 053 (30.6) | 33 (15.6) | 10 026 (15.7) | |||
| TB drugs administration method | Directly observed | 360 (57.0) | 37 518 (47.8) | <0.001 | 73 (34.6) | 26 299 (41.3) | 0.19 |
| Self-administered | 122 (19.3) | 22 188 (28.3) | 77 (36.5) | 19 969 (31.3) | |||
| Both | 145 (22.9) | 18 132 (23.1) | 60 (28.4) | 16 902 (26.5) | |||
| TB provider type | Private/other | 89 (14.1) | 16 932 (21.6) | <0.001 | 46 (21.8) | 13 609 (21.4) | 0.03 |
| Health dept. | 357 (56.5) | 38 328 (48.8) | 115 (54.5) | 37 265 (58.5) | |||
| Both | 183 (29.0) | 22 523 (28.7) | 46 (21.8) | 12 532 (19.7) | |||
TB = tuberculosis; HIV = human immunodeficiency virus; INH = isoniazid; RIF = rifampin
Note that study design limits analysis to patients who were living in the same US state for both TB episodes.
Unknowns for each category are included in the denominator for calculating percentages but are not shown unless the proportion was >2%.
Pearson chi-square test.
Includes non-injection drug use, injection drug use, and excess alcohol use 12 months prior.
Includes those that tested HIV negative, refused, not offered, HIV test done but result unknown, result indeterminate, and result unknown.
Among those with pulmonary disease or both pulmonary and extrapulmonary disease and chest radiograph consistent with TB (among US-born, n=572 for patients with later recurrent TB, n=63,476 for presumed single-episode cases; among foreign-born, n=168 for patients with later recurrent TB, n=48,313 for presumed single-episode cases).
Among patients with a positive sputum culture (among US-born, n=514 for patients with later recurrent TB, n=43,869 for presumed single-episode cases; among foreign-born, n=145 for patients with later recurrent TB; n=35,158 for presumed single-episode cases).