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首页> 外文期刊>American journal of public health >Tuberculosis Incidence Among Populations at High Risk in California, Florida, New York, and Texas, 2011–2015
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Tuberculosis Incidence Among Populations at High Risk in California, Florida, New York, and Texas, 2011–2015

机译：2011-2015年，加利福尼亚州，佛罗里达州，纽约州和德克萨斯州的高危人群中结核病发病率

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Objectives. To illustrate the magnitude of between-state heterogeneities in tuberculosis (TB) incidence among US populations at high risk for TB that may help guide state-specific strategies for TB elimination. Methods. We used data from the National Tuberculosis Surveillance System and other public sources from 2011 to 2015 to calculate TB incidence in every US state among people who were non–US-born, had diabetes, or were HIV-positive, homeless, or incarcerated. We then estimated the proportion of TB cases that reflected the difference between each state’s reported risk factor–specific TB incidence and the lowest incidence achieved among 4 states (California, Florida, New York, Texas). We reported these differences for the 4 states and also calculated and aggregated across all 50 states to quantify the total percentage of TB cases nationally that reflected between-state differences in risk factor–specific TB incidence. Results. On average, 24% of recent TB incidence among high-risk US populations reflected heterogeneity at the state level. The populations that accounted for the greatest percentage of heterogeneity-reflective cases were non–US-born individuals (51%) and patients with diabetes (24%). Conclusions. State-level differences in TB incidence among key populations provide clues for targeting state-level interventions. The United States experienced an average annual decline in tuberculosis (TB) incidence of more than 5% from 1993 to 2014. 1 However, between 2014 and 2016, TB incidence remained essentially flat, at approximately 3.0 cases per 100?000 people per year. 2 To better understand trends and continue progress toward elimination (?1 case/million people/year), 3 it may be useful to identify heterogeneities in TB incidence between states among high-risk populations. 4 Describing the magnitude of such heterogeneity by specific risk factors can provide insights for officials to tailor TB control and prevention activities to the unique public health requirements of each state. Some sources of observed heterogeneity may be unmodifiable, but other components may be actionable. These results can inform state-level investigations and help develop effective targeted interventions. We therefore sought to quantify the differences in TB incidence within selected populations in all 50 US states, benchmarked against TB incidence in 1 of 4 states (California, Texas, New York, Florida). These 4 states currently account for more than half of all new TB cases in the United States and contain large and heterogeneous populations at high risk for TB disease relative to most other states.
机译：目标。为了说明在结核病高风险的美国人群中结核病（TB）发病率的州际异质性程度，这可能有助于指导针对州的结核病消除策略。方法。我们使用了2011年至2015年国家结核病监测系统和其他公共来源的数据来计算非美国出生，患有糖尿病或HIV阳性，无家可归或被监禁的人群在美国每个州的结核病发病率。然后，我们估计了结核病病例的比例，反映了每个州报告的特定危险因素的结核病发病率与4个州（加利福尼亚州，佛罗里达州，纽约州，德克萨斯州）中最低的发病率之间的差异。我们报告了这四个州的这些差异，并且还对所有50个州进行了计算和汇总，以量化全国性结核病病例的总数百分比，反映出各州之间因危险因素而异的结核病发病率差异。结果。平均而言，美国高危人群中近期结核病发病率的24％在州一级反映出异质性。反映异质性的病例所占比例最大的人群是非美国出生的个体（51％）和糖尿病患者（24％）。结论。关键人群中结核病发病率的州级差异为针对州级干预措施提供了线索。从1993年到2014年，美国的结核病发病率平均每年下降超过5％。1然而，在2014年至2016年期间，结核病发病率基本持平，每年每10万人中约有3.0例。 2为了更好地了解趋势并继续朝着消除疾病的目标前进（<1例/百万人/年），3确定高危人群中各州之间结核病发病率的异质性可能是有用的。 4通过特定的风险因素描述这种异质性的程度，可以为官员们提供见解，使他们可以根据每个州独特的公共卫生要求量身定制结核病的控制和预防活动。观察到的异质性的某些来源可能无法修改，但其他组件可能是可操作的。这些结果可以为州一级的调查提供信息，并有助于制定有效的针对性干预措施。因此，我们试图以美国4个州中的1个州（加利福尼亚州，德克萨斯州，纽约州，佛罗里达州）的结核病发病率为基准，对美国所有50个州的特定人群中结核病发病率的差异进行量化。目前，这四个州占美国所有新增结核病病例的一半以上，相对于大多数其他州，这些人群包含结核病高风险的大型异类人群。

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