title: Epidemiology of urban tuberculosis in the United States, 2000-2007.
abstract: OBJECTIVE
  We investigated tuberculosis (TB) incidence rates and characteristics of patients with TB in large US cities.
  
  
  METHODS
  Using the Centers for Disease Control and Prevention's National Tuberculosis Surveillance System data, we categorized 48 cities annually from 2000 to 2007 as reporting decreasing or nondecreasing rates with Joinpoint analysis. We compared demographic, clinical, and treatment characteristics of patients with TB using bivariate and multivariate analyses.
  
  
  RESULTS
  We found that 42 448 patients with TB in 48 cities accounted for 36% of all US patients with TB; these cities comprised 15% of the US population. The average TB incidence rate in the 48 cities (12.1 per 100,000) was higher than that in the US excluding the cities (3.8 per 100,000) but decreased at a faster rate. Nineteen cities had decreasing rates; 29 cities had nondecreasing rates. Patient characteristics did not conclusively distinguish decreasing and nondecreasing rate cities.
  
  
  CONCLUSIONS
  A significant TB burden occurs in large US cities. More than half (60%) of the selected cities did not show decreasing TB incidence rates. Studies of city-level variations in migration, socioeconomic status, and resources are needed to improve urban TB control.
authors.affiliation: Tuberculosis Control Program, Public Health-Seattle and King County, Harborview Medical Center, Seattle, WA 98104, USA. eyal.oren@kingcounty.gov
authors.forename: Eyal
authors.initials: E
authors.lastname: Oren
authors.forename: Carla A
authors.initials: CA
authors.lastname: Winston
authors.forename: Robert
authors.initials: R
authors.lastname: Pratt
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Robison
authors.forename: Masahiro
authors.initials: M
authors.lastname: Narita
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012737:Sex Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult