Predicting U.S. tuberculosis case counts through 2020.

Abstract

In 2010, foreign-born persons accounted for 60% of all tuberculosis (TB) cases in the United States. Understanding which national groups make up the highest proportion of TB cases will assist TB control programs in concentrating limited resources where they can provide the greatest impact on preventing transmission of TB disease. The objective of our study was to predict through 2020 the numbers of U.S. TB cases among U.S.-born, foreign-born and foreign-born persons from selected countries of birth. TB case counts reported through the National Tuberculosis Surveillance System from 2000-2010 were log-transformed, and linear regression was performed to calculate predicted annual case counts and 95% prediction intervals for 2011-2020. Data were analyzed in 2011 before 2011 case counts were known. Decreases were predicted between 2010 observed and 2020 predicted counts for total TB cases (11,182 to 8,117 [95% prediction interval 7,262-9,073]) as well as TB cases among foreign-born persons from Mexico (1,541 to 1,420 [1,066-1,892]), the Philippines (740 to 724 [569-922]), India (578 to 553 [455-672]), Vietnam (532 to 429 [367-502]) and China (364 to 328 [249-433]). TB cases among persons who are U.S.-born and foreign-born were predicted to decline 47% (4,393 to 2,338 [2,113-2,586]) and 6% (6,720 to 6,343 [5,382-7,476]), respectively. Assuming rates of declines observed from 2000-2010 continue until 2020, a widening gap between the numbers of U.S.-born and foreign-born TB cases was predicted. TB case count predictions will help TB control programs identify needs for cultural competency, such as languages and interpreters needed for translating materials or engaging in appropriate community outreach.