title: Differential decline in tuberculosis incidence among US- and non-US-born persons in New York City.
abstract: METHODS
  A large urban tuberculosis control program.
  
  
  OBJECTIVE
  To examine changes in tuberculosis incidence and characteristics of cases in New York City (NYC), and assess the epidemiology of tuberculosis among non-US-born persons.
  
  
  METHODS
  Tuberculosis surveillance data (1995-1999) for NYC were analyzed.
  
  
  RESULTS
  Tuberculosis incidence decreased by 56.6% in US-born and 19.6% in non-US-born persons (age-adjusted) over the study period. The decline in tuberculosis incidence among US-born persons was more substantial in the first half of the study period (23-24%) than in the second half (13-15%). The greatest decline in incidence was among US-born Hispanic or Black males aged 25-64. However, although there was an overall decline in incidence among non-US-born persons, there was no significant change in any sex or racial/ethnic subgroup. The percent of multidrug-resistant (MDR) cases among non-US-born patients remained stable, but recent arrivals accounted for 79% of non-US-born MDR-TB patients in 1999, a significant increase from 16% in 1997.
  
  
  CONCLUSIONS
  Continuing current tuberculosis control efforts and treatment of immigrants with latent tuberculosis infection are of highest priority for reducing incident cases in NYC. Global collaboration towards earlier detection and treatment of active tuberculosis cases in high incidence countries is also essential.
authors.affiliation: Tuberculosis Control Program, New York City Department of Health, New York, New York 10007, USA. jli1@health.nyc.gov
authors.forename: J H
authors.initials: JH
authors.lastname: Li
authors.forename: C R
authors.initials: CR
authors.lastname: Driver
authors.forename: S S
authors.initials: SS
authors.lastname: Munsiff
authors.forename: R
authors.initials: R
authors.lastname: Yip
authors.forename: P I
authors.initials: PI
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D014376:Tuberculosis / Q000208:ethnology*; D018088:Tuberculosis, Multidrug-Resistant / Q000208:ethnology