Epidemiology of tuberculosis among US- and foreign-born children and adolescents in the United States, 1994-2007

Am J Public Health. 2010 Sep;100(9):1724-9. doi: 10.2105/AJPH.2009.181289. Epub 2010 Jul 15.


Objectives: We examined trends in tuberculosis (TB) cases and case rates among US- and foreign-born children and adolescents and analyzed the potential effect of changes to overseas screening of applicants for immigration to the United States.

Methods: We analyzed TB case data from the National Tuberculosis Surveillance System for 1994 to 2007.

Results: Foreign-born children and adolescents accounted for 31% of 18,659 reported TB cases in persons younger than age 18 years from 1994 to 2007. TB rates declined 44% among foreign-born children and adolescents (20.3 per 10,000 to 11.4 per 100,000 population) and 48% (2.1 per 100,000 to 1.1 per 100,000) among those who were born in the United States. Rates were nearly 20 times as high among foreign-born as among US-born adolescents. Among foreign-born children and adolescents with known month of US entry (88%), more than 20% were diagnosed with TB within 3 months of entry.

Conclusions: Marked disparities in TB morbidity persist between foreign- and US-born children and adolescents. These disparities and the high proportion of TB cases diagnosed shortly after US entry suggest a need for enhanced pre- and postimmigration screening.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Emigrants and Immigrants / statistics & numerical data*
  • Emigration and Immigration
  • Female
  • Humans
  • Incidence
  • Infant
  • Male
  • Population Surveillance
  • Tuberculosis / epidemiology*
  • Tuberculosis / ethnology
  • United States / epidemiology