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
Pubmed Central ID
- 22008756
Electronic International Standard Serial Number (EISSN)
- 1815-7920
Digital Object Identifier (DOI)
- 10.5588/ijtld.11.0103
Language
- eng
Conference Location
- France