Trends and Disparities in TB among U.S. Born Black and White Chicago Residents, 1998 - 2008.

OBJECTIVE To describe the decline of tuberculosis (TB) cases among U.S.-born non-Hispanic (NH) black and white Chicago residents. METHODS Data from the National TB Surveillance System was used to analyze trends and characteristics of reported TB cases among U.S.-born NH black and U.S.-born NH white Chicago residents from 1998-2008. RESULTS Chicago reported a total of 3,821 TB cases over the 11-year time period. Of these, 1,916 were U.S.-born NH black and 235 were U.S.-born NH white. The proportion of cases attributable to U.S.-born NH blacks was 63% (294/469) in 1998 and 34% in 2008 (72/213). Regression analysis for trends from 2000-2008 revealed a greater than predicted decrease in rates among U.S.-born NH blacks (p<0.05). U.S.-born NH blacks had greater odds than U.S.-born NH whites of HIV infection (OR 1.8), non-injecting drug use (OR 3.0), unemployment (OR 1.7), receiving care from the health department (OR 2.2) and receiving directly observed therapy (OR 3.0). CONCLUSION Despite more TB risk factors in Chicago's U.S.-born black population, there was a narrowing of TB case disparity in Chicago from 1998-2008. Continued focused strategies aimed at controlling TB are needed.