Disparities in tuberculosis burden among South Asians living in New York City, 2001-2010.

Objectives. We have described the characteristics of South Asian-born tuberculosis (TB) patients living in New York City (NYC) and compared them with other foreign-born patients to explore possible explanations for the disproportionate burden of TB in the South Asian population. Methods. We used data on demographic and clinical characteristics for TB patients identified by the NYC Bureau of Tuberculosis Control from 2001 to 2010 to compare South Asian patients with other Asian and other foreign-born patients. We reviewed genotyping and cluster investigation data for South Asian patients to assess the extent of genotype clustering and the possibility of local transmission in this population. Results. The observed disparity in TB rates and burden among South Asians was not explained by social or clinical characteristics. A large amount of TB strain diversity was observed among South Asians, and they were less likely than other foreign-born patients to be infected with the same TB strain as another NYC patient. Conclusions. The majority of South Asians were likely infected with TB abroad. South Asians represent a meaningful foreign-born subpopulation for targeted detection and treatment of TB infection in NYC.