Age-Period-Cohort Analyses of Tuberculosis Incidence Rates by Nativity, United States, 1996-2016.

Authors:
Shareen A Iqbal
Shareen A Iqbal
Morehouse School of Medicine
Carla A Winston
Carla A Winston
University of Pennsylvania School of Medicine
United States
Barbara H Bardenheier
Barbara H Bardenheier
Centers for Disease Control and Prevention
United States
Lori R Armstrong
Lori R Armstrong
University of Texas Medical Branch
United States

Am J Public Health 2018 Nov;108(S4):S315-S320

Shareen A. Iqbal, Carla A. Winston, Lori R. Armstrong, and Thomas R. Navin are with the Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Barbara H. Bardenheier is with the Division of Global Migration and Quarantine, CDC.

Objectives: To assess changes in US tuberculosis (TB) incidence rates by age, period, and cohort effects, stratified according to race/ethnicity and nativity.

Methods: We used US National Tuberculosis Surveillance System data for 1996 to 2016 to estimate trends through age-period-cohort models.

Results: Controlling for cohort and period effects indicated that the highest rates of TB incidence occurred among those 0 to 5 and 20 to 30 years of age. The incidence decreased by age for successive birth cohorts. There were greater estimated annual percentage decreases among US-born individuals (-7.3%; 95% confidence interval [CI] = -7.5, -7.1) than among non-US-born individuals (-4.3%; 95% CI = -4.5, -4.1). US-born individuals older than 25 years exhibited the largest decreases, a pattern that was not reflected among non-US-born adults. In the case of race/ethnicity, the greatest decreases by nativity were among US-born Blacks (-9.3%; 95% CI = -9.6, -9.1) and non-US-born Hispanics (-5.7%; 95% CI = -6.0, -5.5).

Conclusions: TB has been decreasing among all ages, races and ethnicities, and consecutive cohorts, although these decreases are less pronounced among non-US-born individuals.

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Source
https://ajph.aphapublications.org/doi/10.2105/AJPH.2018.3046
Publisher Site
http://dx.doi.org/10.2105/AJPH.2018.304687DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215379PMC
November 2018
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