Infectious Disease

TB incidence higher in the US among older adults, but declining rapidly within birth cohorts

September 11, 2021

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Kim does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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According to a study in Clinical Infectious Diseases, the incidence of tuberculosis is high in people aged 50 years or older in the United States, but is rapidly decreasing within subsequent birth cohorts.

As an example, the researchers found that “in 2001 the average 50-year-old could expect their annual risk of TB to decrease by 77% by the time they turned 68 in 2019.”

Source: Adobe Stock.

The risk of tuberculosis in the USA decreases with the following birth cohorts. Source: Adobe Stock.

Sun Kim

“Although we found strong evidence that the annual percentage decline was lower in the elderly, the annual reduction in TB risk in the oldest age group in our sample was still over 4%.” Sun Kim, MRS, a graduate student in population health at Harvard TH Chan School of Public Health, and colleagues wrote.

“Most TB cases in the United States result from reactivation of latent TB infection (LTBI), with the incidence highest in the elderly population,” Kim told Healio. “While observational cohort studies have shown that the risk of LTBI reactivation decreases up to 20 years after infection, there is little empirical evidence of how the risks of LTBI progression change for those with distant infection.”

According to Kim and colleagues, 42,000 TB cases were reported among US citizens aged 50 or older between 2001 and 2019. Race / Ethnicity. ”The study showed that estimated incidence rates decreased with age – for the entire cohort and most Gender and race / ethnicity classes.

According to the study, the mean annual decrease in incidence rates in older participants flattened from 8.8% (95% CI 8.34–9.23) in 51-year-olds to 4.51% (95% CI, 3, 87-5.14) in 90-year-olds. After controlling for age, the researchers found that the incidence rates were lower for younger cohorts, falling on average by 8.79% (95% CI, 6.13-11.26) between consecutive cohort years.

In addition, the researchers found that the incidence rates for racial or ethnic minorities were significantly higher in all birth cohorts, while the rates decreased by about 10% per year with age due to the recent infection.

“Ensuring that TB prevention services target the needs of vulnerable and vulnerable populations is likely to increase the impact of the prevention services and mitigate the health effects of the inequalities estimated in this analysis,” said Kim.

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