TB successes and challenges in U.S. reflect those abroad

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MMWRMARCH212014The Centers for Disease Control and Prevention is recognizing next week’s World TB Day with a report documenting continued progress against tuberculosis at in the United States, along with an troubling trend. The progress: the 3.0 cases per 100,000 people reported in 2013 (9,588 new cases) represents a more than 4 percent drop from 2012. The troubling part is that progress still is not shared equally: while incidence also dropped among foreign-born people in the United States, it is not dropping as fast as it is for those born in the United States. That means that the proportion of the impact of tuberculosis on people born outside of the United States is increasing, with their rate of the disease about thirteen times that of people born here. With TB elimination defined as less than one case per 100,000 people, the goal of eliminating tuberculosis in the United States remains unreached.

The report, which is in this week’s CDC Morbidity and Mortality Weekly Report, notes that the data highlight a continued need for strategies better tailored to reach specific populations, the need to improve surveillance and then to effectively respond. At the same time, this week’s MMWR also includes a report showing that worldwide implementation of improved TB screening requirements for immigrant and refugee visas into the United States have led to more people receiving treatment for tuberculosis before coming to the United States. Collaboration between immigration screening programs and in-country TB programs would maximize the the benefits beyond people heading for the United States, the report notes.

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