Countries of Origin of Foreign-Born Cases of Tuberculosis (TB) Diagnosed in the United States
Over 70% of the 6,854 foreign-born TB cases reported in the United States in 2009 were in persons born in only 12 countries.
In the United States, the number of TB cases reported in foreign-born persons has remained virtually level, with approximately 7,000 to 8,000 cases reported each year from 1993 to 2008. But in 2009, the number of cases dropped to 6,854. That same year, cases among U.S.-born persons decreased to 4,571. In 2009, the percentage of TB cases occurring in foreign-born persons was 59% of the national total. Foreign-born Hispanics and Asians together represented 80% of reported TB cases in foreign-born persons, and accounted for 48% of the national total.
The top 12 countries of origin of foreign-born persons with TB in the United States in 2009 were: Mexico, Philippines, Vietnam, India, China, Haiti, Republic of Korea, Guatemala, Peru, El Salvador, Ethiopia, and Honduras. Of the 6,854 TB cases reported in 2009 among foreign-born persons, 40% occurred among persons born in the Americas region1, and 30% occurred among persons born in the Western Pacific region. From 1993 to 2009, the proportion of reported cases increased among persons born in the Eastern Mediterranean region (3% in 1993 to 4.6% in 2009), the Southeast Asia region (6% in 1993 to 13% in 2009), and the African region (2% in 1993 and 8% in 2009).
Although the TB case rate (number of cases per 100,000 population) in the United States has declined annually in both U.S.-born and foreign-born persons, there has been a faster decline among U.S.-born persons (a 77% decrease since 1993) than among foreign-born persons (a 45% decrease since 1993).
To address the high TB case rates among foreign-born persons, CDC is collaborating with other national and international public health organizations to improve screening of immigrants and refugees, test recent arrivals from countries with high rates of TB, and improve TB control activities along the border between the United States and Mexico. CDC has developed medical screening guidelines called technical instructions2 for the TB testing and treatment of those who seek permanent residence in the United States (refugees and immigrants). TB is a challenging disease to diagnose, treat, and control. Our united effort is needed to reach those at highest risk for TB, and to identify and implement innovative strategies to improve testing and treatment among high risk populations.
CDC. Reported Tuberculosis in the United States, 2009 [PDF - 4.99MB]. Atlanta, GA: U.S. Department of Health and Human Services, CDC, October 2010.
- World Health Organization (WHO). Global Tuberculosis Control 2009: Epidemiology, Strategy, Financing. Geneva, Switzerland: WHO, 2009 (WHO/HTM/TB/2009.411)
- CDC. CDC Immigration Requirements: Technical Instructions for Tuberculosis Screening and Treatment [PDF - 315KB]. Atlanta, GA: U.S. Department of Health and Human Services, CDC, October 2009.
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