The Influence of Age at Arrival and Duration of Residence in US on Prevalence of Latent TB Infection

Rationale and Background: Screening for and treatment of latent tuberculosis infection (LTBI) among foreignborn persons living in the United States (U.S.) has been identified as an important public health priority. In order to reach the goal of tuberculosis (TB) elimination in the U.S., screening and treatment of LTBI will need to be expanded. Objectives: To estimate the relationship between age at arrival in the U.S., among foreign-born persons, duration of U.S. residence and risk for LTBI, simultaneously. Methods: We examined participants in the 1999-2000 and 2011-2012 NHANES surveys to assess the association between foreign birth, age, and length of time in the U.S. and prevalence of LTBI. Results: Overall, 1.7% of U.S-born and 19.2% of foreign-born persons had LTBI. In unadjusted regression models, increasing age and shorter length of time in the U.S. were associated with increased prevalence of LTBI: OR=1.3 (1.2, 1.4) for every 10 year increase in age and OR=0.97 (0.84, 1.1) for every 10 year increase in of duration of years in U.S. Conclusions: Both of these factors should be considered when prioritizing foreign-born populations for LTBI screening and treatment in the U.S.