The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67921

DE Bennett, MD, MPH¹, JM Courval, PhD¹, IM Onorato, MD¹, T Agerton, PhD¹, Judy M Daugherty-Gibson, MSN, RN², Geraldine McQuillan, PhD³, Brenda Lewis³, Kenneth Castro, MD⁴, and Kimberly Willis Field, RN, MSN⁵. (1) Division of TB Elimination, Centers for Disease Control and Prevention, MS E-47 DHAP NCHSTP, 1600 Clifton Road NE, Atlanta, GA 30333, 1-404-639-5349, dbennett@cdc.gov, (2) Division of TB Elimination, National Center for HIV, STD, TB Prevention, Centers for Disease Control and Prevention, PO Box 95525, Atlanta, GA 30347, (3) Division of Health Examination Statistics, National Center for Health Statistics/CDC, 6525 Belcrest Rd, Room 1000, Hyattsville, MD 20782, (4) Division of Tuberculosis Elimination, Centers for Disease Control, 11 Corporate Square Blvd., Rm 2106, Atlanta, GA 30329, (5) Tuberculosis Control Manager, Washington State Department of Health, WA

Background: The prevalence of TB infection (TBI) in the US has not been estimated since the first National Health and Nutrition Examination Survey (NHANES). To obtain an updated estimate, a TB component was included in NHANES 1999-2000. Methods: NHANES subjects were selected using a hierarchical stratified random sampling procedure to represent the non-institutionalized civilian US population. TBI was defined as a reaction of > 10 mm to a tuberculin skin test given to consenting participants over one year of age. NHANES weights were applied for the analysis. A p value of < 0.05 were considered significant. Results are preliminary. Results: Of 8832 eligible participants, 7386 (84%) had TST placed and returned for measurement. The overall weighted prevalence of TBI was 4.2% [95% Confidence Intervals (CI) 3.3-5.1]. Among the subgroup 25-74 years of age, TBI prevalence fell significantly between 1971-1972 [16.1% (CI 13.5- 18.7)] and 1999-2000 [5.5% (CI 4.2- 6.9)] . In a logistic regression model without interaction terms, foreign birth [Odds ratio (OR) 9.8], Mexican-American race/ethnicity [OR 3.6], poverty [OR 2.3], male gender [OR 1.9], and the age groups (in years of age) 25-44 [OR 3.4], 45-64 [OR 6.5], and 65+ [OR 6.3] were associated with TBI. Discussion: TB infection has declined in the US population since the early 1970s. Populations with higher rates of TBI include persons born outside the US, Mexican-Americans, and persons living in poverty. Providing prevention, evaluation and treatment services to high-risk groups is important for elimination of TB in the U.S.

Learning Objectives:

• (1)Participants will be able to describe the methods used in the National Health and Nutrition Examination Survey to estimate the prevalence of TB infection in the US population in 1971-72 and 1999-2000
• (2)Participants will be able to compare the prevalence of tuberculosis infection in the US 1999-2000 to the prevalence in 1971-72
• (3)Participants will be able to list the groups at higher risk for TB infection in the US

Keywords: Tuberculosis, Epidemiology

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Purified Protein Derivatives S-1 and B were used under an IND from the FDA both in NHANES 1999-2000 and NHANES 1971-72. These are held in the FDA laboratory for CDC. PPD S-1 is the standard against which commerical tuberculin tests are compared. There
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.