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Thomas M. Weiser, MD, MPH, Whiteriver IHS Hospital, PO Box 860, Whiteriver, AZ 85941, 928-338-4911, tom.weiser@mail.ihs.gov
Tuberculosis incidence has steadily decreased in the United States and in Arizona over the past ten years. This is true for all racial/ethnic categories, including Native Americans. To better understand the epidemiology of tuberculosis (TB) among the White Mountain Apache, data from patient chart reviews was collected. From 1990 to 2003, the annual incidence of active TB decreased from 40/100,000 to 7/100,000 (5 cases/year to 1 case/year). The number of active TB cases has remained low (<3 cases/year) for the past 10 years. The age distribution ranged from 18 to 76 years. Risk factors included alcoholism, diabetes, end-stage renal disease and alcoholic liver disease. Most cases were reactivation of old infection with the average duration of positive PPD being 17 years. Five of 29 cases (17%) were positive for one year or less representing newly acquired infection. Latent TB infection, as assessed by skin test conversion, decreased during the period of annual skin testing (1990-2000) from 3.5% to 0.6%.
Conclusion: The incidence of active TB infection among the White Mountain Apache has decreased and is equal to the national rate for all Native Americans. The absence of new cases among children coupled with the low rate of new PPD conversions suggest that transmission of TB is declining in this community. This example of epidemiologic transition in a Native American community may have implications for TB control planning in other Native American communities.
*Note: Abstract submitted pending Tribal and Phoenix Area IHS review and approval.
Learning Objectives:
Keywords: Native Americans, Tuberculosis
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.