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Arch Pediatr Adolesc Med. 2006 Jun;160(6):631-7.

Racial and ethnic disparities in pediatric tuberculosis in North Carolina.

Author information

1
Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA. stout002@mc.duke.edu

Abstract

OBJECTIVES:

To investigate an increase in active pediatric tuberculosis (TB) cases in North Carolina from 9 cases in 2001 to 32 cases in 2002, and to pilot test a screening tool for detection of latent TB infection in children.

DESIGN:

Retrospective cohort and cross-sectional study.

SETTING:

State of North Carolina and a county public health department pediatric clinic.

PARTICIPANTS:

Children younger than 15 years with TB in North Carolina from January 1, 1994, to December 31, 2002, and children younger than 21 years initially seen in a primary care public health department pediatric clinic from July 16, 2004, to December 8, 2004.

INTERVENTIONS:

We reviewed medical records for 180 children (<15 years) with active TB reported in North Carolina. We subsequently initiated a screening project at a county public health department pediatric clinic.

MAIN OUTCOME MEASURES:

Incidence of TB and prevalence of latent TB infection.

RESULTS:

One hundred eighty pediatric TB cases were reported from 1994 to 2002. Compared with 0.2 case per 100 000 non-Hispanic white children, the incidence rates were 3.0 cases per 100 000 non-Hispanic black children (P = .003) and 4.5 cases per 100 000 Hispanic children (P = .01); 88.3% of pediatric patients with TB were nonwhite. The screening project detected 2 cases of latent TB infection among 864 US-born children of foreign-born parents.

CONCLUSIONS:

The burden of pediatric TB is almost entirely borne by black and Hispanic children in North Carolina. Tuberculin skin testing of US-born children of foreign-born parents is of low yield; more efficient screening strategies are necessary.

PMID:
16754826
DOI:
10.1001/archpedi.160.6.631
[Indexed for MEDLINE]

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