Tuberculosis among American Indians and Alaska Natives in the United States, 1993-2002.

OBJECTIVES: I examined trends in and epidemiological and clinical characteristics of tuberculosis (TB) within the American Indian/Alaska Native (AIAN) population of the United States and compared TB trends and characteristics in that population with TB trends and characteristics within other racial/ethnic groups. METHODS: I analyzed all verified cases of TB reported to the US National Tuberculosis Surveillance System from January 1, 1993, to December 31, 2002. RESULTS: From 1993 through 2002, 196133 TB cases were reported, 2612 (1.3%) of which were in the AIAN population. During this period, TB case rates declined 40.4% among AIAN peoples, the smallest decrease among any US-born racial/ethnic group. In 2002, 15075 TB cases (5.2 per 100000 population) were reported, 180 of which were in the AIAN population (8.4 per 100000 population)-almost 6 times the rate for non-Hispanic Whites (1.5 per 100000 population). CONCLUSIONS: TB continues to be a significant health problem for the AIAN population. Vigilance and collaboration among local, state, federal, AIAN, and tribal TB control programs are essential to TB elimination among the AIAN population.