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Tuberculosis in the United States National Surveillance System Highlights from 2005 Division of Tuberculosis Elimination Centers for Disease Control and Prevention Reported TB Cases* United States, 1982–2005 No. of Cases 28,000 26,000 24,000 22,000 20,000 18,000 16,000 14,000 12,000 10,000 1982 1985 1995 1990 Year *Updated as of March 29, 2006 2000 2005 TB Morbidity United States, 2000–2005 Year Cases Rate* 2000 2001 2002 2003 2004 2005 16,309 15,946 15,056 14,840 14,515 14,097 5.8 5.6 5.2 5.1 4.9 4.8 *Cases per 100,000, updated as of March 29, 2006. TB Case Rates,* United States, 2005 D.C. < 3.5 (year 2000 target) 3.6–4.8 > 4.8 (national average) *Cases per 100,000. Cases per 100,000 TB Case Rates* by Age Group United States, 1993–2005 20 15 10 5 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 <15 15–24 *Updated as of March 29, 2006. 25–44 45–64 >65 Reported TB Cases by Age Group, United States, 2005 >65 yrs (20%) 45–64 yrs (29%) <15 yrs (6%) 15–24 yrs (11%) 25–44 yrs (34%) Cases per 100,000 TB Case Rates by Age Group and Sex, United States, 2005 12 10 8 6 4 2 0 <15 yrs 15–24 yrs 25–44 yrs Male 45–64 yrs Female >65 yrs Cases per 100,000 TB Case Rates by Race/Ethnicity* United States, 1993–2005** 50 40 30 20 10 0 1993 1995 1997 1999 2001 2003 Asian/Pacific Islander American Indian/Alaska Native Black or African-American Hispanic White *All races are non-Hispanic. In 2003, Asian/Pacific Islander category includes persons who reported race as Asian only and/or Native Hawaiian or Other Pacific Islander only. **Updated as of March 29, 2006. 2005 Reported TB Cases by Race/Ethnicity* United States, 2005 American Indian or Alaska Native (1%) White (18%) Asian (23%) Native Hawaiian or Other Pacific Islander (<1%) Hispanic or Latino (29%) Black or African-American (28%) *All races are non-Hispanic. Persons reporting two or more races accounted for less than 1% of all cases. Cases per 100,000 TB Case Rates by Age Group and Race/Ethnicity,* United States, 2005 100 80 60 40 20 0 <5 5–14 15–24 25–44 45–64 >65 Age Group (yrs) American Indian/Alaska Native Asian Hispanic or Latino Black or African-American White Native Hawaiian/Other Pacific Islander *All races are non-Hispanic. Persons reporting two or more races accounted for less than 1% of all cases. No. of Cases Number of TB Cases in U.S.-born vs. Foreign-born Persons United States, 1993–2005* 20000 15000 10000 5000 0 1993 1995 1997 1999 U.S.-born *Updated as of March 29, 2006. 2001 Foreign-born 2003 2005 Trends in TB Cases in Foreign-born Persons, United States, 1986–2005* No. of Cases Percentage 10,000 60 50 40 8,000 6,000 30 20 10 0 4,000 2,000 0 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 No. of Cases *Updated as of March 29, 2006. Percentage of Total Cases Reported TB Cases by Origin and Race/Ethnicity,* United States, 2005 U.S.-born Foreign-born** American Indian or Alaska Native Asian (2%) (2%) White (34%) Native Hawaiian/Other Pacific Islander (<1%) Hispanic or Latino (15%) White (6%) Hispanic or Latino (40%) Asian (40%) Black or AfricanAmerican (45%) Black or AfricanAmerican (14%) *All races are non-Hispanic. Persons reporting two or more races accounted for less than 1% of all cases. **American Indian or Alaska Native and Native Hawaiian or Other Pacific Islander accounted for less than 1% of foreign-born cases and are not shown. Percentage of TB Cases Among Foreign-born Persons, United States* 1995 2005 DC DC >50% 25%–49% <25% *Updated as of March 29, 2006. Cases per 100,000 TB Case Rates in U.S.-born vs. Foreign-born Persons United States, 1993–2005* 40 30 20 10 0 1993 1995 1997 U.S. Overall *Updated as of March 29, 2006. 1999 U.S.-born 2001 2003 Foreign-born 2005 Cases per 100,000 TB Case Rates in U.S.-born vs. Foreign-born Persons United States,* 1993–2005** 100 10 1 1993 1995 1997 U.S. Overall 1999 U.S.-born 2001 2003 Foreign-born *Includes the same data as slide 15, but rates presented on a logarithmic scale. **Updated as of March 29, 2006. 2005 Countries of Birth of Foreign-born Persons Reported with TB United States, 2005 Mexico (25%) Other Countries (38%) Philippines (11%) Guatemala (3%) Haiti (3%) China (5%) India (7%) Viet Nam (8%) Percent of Foreign-born with TB by Time of Residence in U.S. Prior to Diagnosis,* 2005 100% 80% 60% 40% 20% 0% All Mexico <1 yr Philippines 1–4 yrs >5 yrs *Data exclude foreign-born TB patients for when length of residence in the U.S. prior to diagnosis was unknown. Viet Nam Primary Anti-TB Drug Resistance United States, 1993–2005* % Resistant 10 5 0 1993 1995 1997 1999 Isoniazid 2001 2003 MDR TB *Updated as of March 29, 2006. Note: Based on initial isolates from persons with no prior history of TB. MDR TB defined as resistance to at least isoniazid and rifampin. 2005 Primary MDR TB United States, 1993–2005* No. of Cases Percentage 500 400 300 200 100 0 3 2 1 0 93 94 95 96 97 98 99 00 01 02 03 04 05 No. of Cases Percentage *Updated as of March 29, 2006. Note: Based on initial isolates from persons with no prior history of TB. MDR TB defined as resistance to at least isoniazid and rifampin. % Resistant Primary Isoniazid Resistance in U.S.-born vs. Foreign-born Persons United States, 1993–2005* 14 12 10 8 6 4 2 0 1993 1995 1997 U.S.-born 1999 2001 2003 Foreign-born *Updated as of March 29, 2006. Note: Based on initial isolates from persons with no prior history of TB. 2005 % Resistant Primary MDR TB in U.S.-born vs. Foreign-born Persons, United States, 1993–2005* 3 2 1 0 1993 1995 1997 1999 U.S.-born 2001 Foreign-born *Updated as of March 29, 2006. Note: Based on initial isolates from persons with no prior history of TB. MDR TB defined as resistance to at least isoniazid and rifampin. 2003 2005 % with Test Results Reporting of HIV Test Results in Persons with TB by Age Group United States, 1993–2004* 80 60 40 20 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 All Ages Aged 25–44 *Updated as of March 29, 2006. Note: Includes TB patients with positive, negative, or indeterminate HIV test results and persons from California reported with AIDS. (HIV test results are not reported from California) % Coinfection Estimated HIV Coinfection in Persons Reported with TB, United States, 1993–2004* 30 20 10 0 1993 1995 1997 All Ages 1999 2001 Aged 25–44 *Updated as of March 29, 2006. Note: Minimum estimates based on reported HIV-positive status among all TB cases in the age group. 2003 Mode of Treatment Administration in Persons Reported with TB United States, 1993–2003* 100% 80% 60% 40% 20% 0% 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 DOT only DOT + SA SA only *Updated as of March 29, 2006. Directly observed therapy (DOT); Self-administered therapy (SA) Completion of TB Therapy United States, 1993–2003* ** 80 60 40 20 Completed 03 20 02 20 01 20 00 20 99 19 98 19 97 19 96 19 95 19 94 19 93 0 19 Percentage 100 Completed in 1 yr or less *Updated as of March 29, 2006. **Healthy People 2010 target: 90% completed in 1 yr or less. Note: Persons with initial isolate resistant to rifampin and children under 15 years old with meningeal, bone or joint, or miliary disease excluded.