Increased prevalence of advanced tuberculosis in rural low tuberculosis caseload counties in North Carolina.

Journal Article (Journal Article)

SETTING: Pulmonary tuberculosis (TB) patients reported in North Carolina (NC), USA, from 1996 to 2008 (inclusive). OBJECTIVE: To compare prevalence of cavitary TB as a surrogate marker for advanced disease in low-caseload counties with high-caseload counties. DESIGN: A multivariate log binomial regression model was used to estimate prevalence ratios (PRs) for cavitary TB. RESULTS: The proportion of TB cases in low-caseload counties vs. the total number of TB cases in NC over the study period increased from 10% in 1996 to 20% in 2008. After adjusting for human immunodeficiency virus (HIV) status, excess alcohol use and report year, patients in rural areas of low-caseload counties had greater prevalence (PR 1.40, 95%CI 1.19-1.64) of cavitary disease compared with patients from rural areas of high-caseload counties. The prevalence of cavitary TB did not differ between urban residents of high- or low-caseload counties (PR 1.00, 95%CI 0.86-1.16) after adjusting for HIV status, excess alcohol use and report year. DISCUSSION: TB patients in rural areas of low-caseload counties presented with more advanced TB disease compared with patients from urban and/or high-caseload counties. Barriers to timely recognition of TB in rural low-caseload settings must be considered in TB control programs.

Full Text

Duke Authors

Cited Authors

  • Guderian, LJ; Miller, WC; Seña, AC; Stout, JE

Published Date

  • November 2011

Published In

Volume / Issue

  • 15 / 11

Start / End Page

  • 1455 - i

PubMed ID

  • 22008756

Electronic International Standard Serial Number (EISSN)

  • 1815-7920

Digital Object Identifier (DOI)

  • 10.5588/ijtld.11.0103


  • eng

Conference Location

  • France