Hospitalization Rates of Tuberculosis in U.S. Navy Enlisted Personnel: A 15-YearPerspective

摘要

Tuberculosis (TB) has been a scourge of mankind since ancient times, and eventoday it remains one of the foremost causes of disability and death throughout the world. Despite decades of successful control and decreasing rates in the United States, TB is making a comeback. In 1992, 26,673 cases of active TB were reported to the Centers for Disease Control, up 20% from 1985, when resurgence of the disease began. Twenty-two states in 1992 reported increases over 1991 in the number of TB cases reported. The largest increases occurred in Virginia (20.6%), Illinois (6.5%), New York (3.3%), and California (2.1%). The primary factors thought to be responsible for this increase in TB incidence are immigration from high-prevalence countries; confection with HIV; social disruption, including homelessness and drug abuse; outbreaks of TB which occur in congregative facilities; and the recent appearance of multiple drug-resistant TB. The worldwide incidence of TB is expected to increase substantially over the next 10 years. An estimated 7.5 million incident cases of TB occurred worldwide during 1990. Approximately 4.9 million cases (66%) occurred in the Southeast Asian and Western Pacific regions; India (2.1 million), China (1.3 million), and Indonesia (0.4 million) accounted for the largest number of cases. On April 23, 1993, the World Health Organization declared TB a global public health emergency, a distinction never accorded another disease. All recruits entering the Navy are screened for a number of diseases, including both HIV and TB.