title: Epidemiology of tuberculosis in young children in the United States.
abstract: OBJECTIVE
  To estimate tuberculosis (TB) rates among young children in the United States by children's and parents' birth origins and describe the epidemiology of TB among young children who are foreign-born or have at least 1 foreign-born parent.
  
  
  METHODS
  Study subjects were children <5 years old diagnosed with TB in 20 US jurisdictions during 2005-2006. TB rates were calculated from jurisdictions' TB case counts and American Community Survey population estimates. An observational study collected demographics, immigration and travel histories, and clinical and source case details from parental interviews and health department and TB surveillance records.
  
  
  RESULTS
  Compared with TB rates among US-born children with US-born parents, rates were 32 times higher in foreign-born children and 6 times higher in US-born children with foreign-born parents. Most TB cases (53%) were among the 29% of children who were US born with foreign-born parents. In the observational study, US-born children with foreign-born parents were more likely than foreign-born children to be infants (30% vs. 7%), Hispanic (73% vs. 37%), diagnosed through contact tracing (40% vs. 7%), and have an identified source case (61% vs. 19%); two-thirds of children were exposed in the United States.
  
  
  CONCLUSIONS
  Young children who are US born of foreign-born parents have relatively high rates of TB and account for most cases in this age group. Prompt diagnosis and treatment of adult source cases, effective contact investigations prioritizing young contacts, and targeted testing and treatment of latent TB infection are necessary to reduce TB morbidity in this population.
authors: Department of Epidemiology, University of Washington, Seattle, Washington;
authors: Jenny
authors: J
authors: Pang
authors: Larry D
authors: LD
authors: Teeter
authors: Dolly J
authors: DJ
authors: Katz
authors: Amy L
authors: AL
authors: Davidow
authors: Wilson
authors: W
authors: Miranda
authors: Kirsten
authors: K
authors: Wall
authors: Smita
authors: S
authors: Ghosh
authors: Trudy
authors: T
authors: Stein-Hart
authors: Blanca I
authors: BI
authors: Restrepo
authors: Randall
authors: R
authors: Reves
authors: Edward A
authors: EA
authors: Graviss
mesh_terms: D002675:Child, Preschool; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D012307:Risk Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: epidemiology; foreign birth; tuberculosis; young children