Racial and ethnic disparities in pediatric tuberculosis in North Carolina

Arch Pediatr Adolesc Med. 2006 Jun;160(6):631-7. doi: 10.1001/archpedi.160.6.631.

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Black People
  • Black or African American
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Hispanic or Latino
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • North Carolina / epidemiology
  • Prevalence
  • Retrospective Studies
  • Tuberculosis / diagnosis
  • Tuberculosis / epidemiology*