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. 2016 Aug 15;194(4):501-9.
doi: 10.1164/rccm.201508-1683OC.

The Prevalence of Latent Tuberculosis Infection in the United States

James D Mancuso  1 , Jeffrey M Diffenderfer  1   2 , Bijan J Ghassemieh  3 , David J Horne  3   4   5 , Tzu-Cheg Kao  1
Affiliations

The Prevalence of Latent Tuberculosis Infection in the United States

James D Mancuso et al. Am J Respir Crit Care Med. .

Abstract

Rationale: Individuals with latent tuberculosis infection (LTBI) represent a reservoir of infection, many of whom will progress to tuberculosis (TB) disease. A central pillar of TB control in the United States is reducing this reservoir through targeted testing and treatment.

Objectives: To estimate the prevalence of LTBI in the United States using the tuberculin skin test (TST) and an IFN-γ release assay.

Methods: We used nationally representative data from the 2011-2012 National Health and Nutrition Examination Survey (n = 6,083 aged ≥6 yr). LTBI was measured by both the TST and QuantiFERON-TB Gold In-Tube test (QFT-GIT). Weighted population, prevalence, and multiple logistic regression were used.

Measurements and main results: The estimated prevalence of LTBI in 2011-2012 was 4.4% as measured by the TST and 4.8% by QFT-GIT, corresponding to 12,398,000 and 13,628,000 individuals, respectively. Prevalence declined slightly since 2000 among the U.S. born but remained constant among the foreign born. Earlier birth cohorts consistently had higher prevalence than more recent ones. Higher risk groups included the foreign born, close contact with a case of TB disease, and certain racial/ethnic groups.

Conclusions: After years of decline, the prevalence of LTBI remained relatively constant between 2000 and 2011. A large reservoir of 12.4 million still exists, with foreign-born persons representing an increasingly larger proportion of this reservoir (73%). Estimates and risk factors for LTBI were generally similar between the TST and QFT-GIT. The updated estimates of LTBI and associated risk groups can help improve targeted testing and treatment in the United States.

Keywords: IFN-γ release tests; latent tuberculosis; nutrition survey; tuberculin test; tuberculosis epidemiology.

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Figures

Figure 1.
Figure 1.
Trend in the prevalence of latent tuberculosis infection in the United States, ages 25–74 years, based on tuberculin skin test reactivity. Error bars represent 95% confidence intervals, which were calculated based on SEs incorporating the complex sample design. Latent tuberculosis was defined by a tuberculin skin test reading of greater than or equal to 10 mm induration.
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References

    1. Scott C, Kirking HL, Jeffries C, Price SF, Pratt R. Centers for Disease Control and Prevention (CDC) Tuberculosis trends—United States, 2014. MMWR Morb Mortal Wkly Rep . 2015;64:265–269. - PMC - PubMed
    1. Division of Tuberculosis Elimination Reported tuberculosis in the United States, 2013. Atlanta, GA: Centers for Disease Control and Prevention; 2014.
    1. Geiter L. Ending neglect: the elimination of tuberculosis in the United States. Washington, DC: National Academy Press; 2000. - PubMed
    1. Hill AN, Becerra J, Castro KG. Modelling tuberculosis trends in the USA. Epidemiol Infect . 2012;140:1862–1872. - PubMed
    1. Ferebee SH. The epidemiological basis of tuberculosis control. Bull Natl Tuberc Assoc . 1967;53:4–8.

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