title: Epidemiology of tuberculosis among US- and foreign-born children and adolescents in the United States, 1994-2007.
abstract: OBJECTIVE
  We examined trends in tuberculosis (TB) cases and case rates among US- and foreign-born children and adolescents and analyzed the potential effect of changes to overseas screening of applicants for immigration to the United States.
  
  
  METHODS
  We analyzed TB case data from the National Tuberculosis Surveillance System for 1994 to 2007.
  
  
  RESULTS
  Foreign-born children and adolescents accounted for 31% of 18,659 reported TB cases in persons younger than age 18 years from 1994 to 2007. TB rates declined 44% among foreign-born children and adolescents (20.3 per 10,000 to 11.4 per 100,000 population) and 48% (2.1 per 100,000 to 1.1 per 100,000) among those who were born in the United States. Rates were nearly 20 times as high among foreign-born as among US-born adolescents. Among foreign-born children and adolescents with known month of US entry (88%), more than 20% were diagnosed with TB within 3 months of entry.
  
  
  CONCLUSIONS
  Marked disparities in TB morbidity persist between foreign- and US-born children and adolescents. These disparities and the high proportion of TB cases diagnosed shortly after US entry suggest a need for enhanced pre- and postimmigration screening.
authors.affiliation: US Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-10, Atlanta, GA 30333, USA. hmenzies@cdc.gov
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Menzies
authors.forename: Carla A
authors.initials: CA
authors.lastname: Winston
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Holtz
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Cain
authors.forename: William R
authors.initials: WR
authors.lastname: Mac Kenzie
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011159:Population Surveillance; D014376:Tuberculosis / Q000453:epidemiology* / Q000208:ethnology; D014481:United States / Q000453:epidemiology