Influence of County Sampling on Past Estimates of Latent Tuberculosis Infection Prevalence

• Type of Material: Article
• Authors: Maryam Haddad, Emory University; Kala Marks Raz, Centers for Disease Control and Prevention; Andrew Hill, Emory University; Thomas R. Navin, Centers for Disease Control and Prevention; Carla A. Winston, Centers for Disease Control and Prevention; Kenneth G. Castro, Emory University; Neel R. Gandhi, Emory University; Timothy L Lash, Emory University
• Language: English
• Date: 2019-08-01
• Publisher: American Thoracic Society
• Publication Version: Final Published Version
• Copyright Statement: © 2019 by the American Thoracic Society
• Final Published Version (URL): http://dx.doi.org/10.1513/AnnalsATS.201901-062RL
• Title of Journal or Parent Work: Annals of the American Thoracic Society
• ISSN: 2329-6933
• Volume: 16
• Issue: 8
• Start Page: 1069
• End Page: 1071
• Grant/Funding Information: This is publicly funded research by employees of the Centers of Disease Control and Prevention (M.B.H., K.M.R., A.N.H., T.R.N., C.A.W.).; Also supported by an existing U.S. Agency for International Development Intergovernmental Personnel Act agreement with Emory University (K.G.C.) and a K24 grant (1K24AI114444) funded by National Institute of Allergy and Infectious Diseases, National Institutes of Health, U.S. Department of Health and Human Services (N.R.G.)
• Keywords: Science & Technology; Life Sciences & Biomedicine; Respiratory System; UNITED-STATES
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

The National Health and Nutrition Examination Survey (NHANES) has tested for Mycobacterium tuberculosis infection three times: in 1971–1972, 1999–2000, and 2011–2012. Based on tuberculin skin test results, the estimated national prevalence of latent tuberculosis infection (LTBI) among adults was 11–18% in 1971–1972 but has remained less than or equal to 6% in subsequent NHANES cycles (1–4). A single 2-year NHANES cycle is designed to produce accurate and stable estimates for conditions with at least 10% prevalence in the noninstitutionalized civilian U.S. population (5–7), suggesting that NHANES might no longer be as nationally representative for LTBI as it is for more common health conditions. Approximately 30 counties were selected for each 2-year cycle (5). We wished to examine whether persons in selected counties might have been systematically more or less likely to have a positive tuberculin skin test result than their counterparts in the approximately 3,100 counties that were not selected for NHANES participation.