Download 2007 Surveillance Slide Set on Tuberculosis in the United States

Tuberculosis in the United States
National Tuberculosis Surveillance System
Highlights from 2007
Division of Tuberculosis Elimination
Centers for Disease Control and Prevention
Reported TB Cases*
United States, 1982–2007
No. of Cases
28,000
26,000
24,000
22,000
20,000
18,000
16,000
14,000
12,000
10,000
1983
1986
1989
1992
1995
Year
*Updated as of April 23, 2008.
1998
2001
2004
2007
TB Morbidity
United States, 2002–2007
Year
No.
Rate*
2002
2003
2004
2005
2006
15,056
14,837
14,501
14,065
13,754
5.2
5.1
4.9
4.7
2007
13,299
*Cases per 100,000, updated as of April 23, 2008.
4.6
4.4
TB Case Rates,* United States, 2007
D.C.
< 3.5 (year 2000 target)
3.6–4.4
> 4.4 (national average)
*Cases per 100,000.
Cases per 100,000
TB Case Rates* by Age Group
United States, 1993–2007
20
15
10
5
0
1993
1995
<15
1997
15–24
*Updated as of April 23, 2008.
1999
2001
25–44
2003
45–64
2005
2007
>65
Reported TB Cases by Age
Group, United States, 2007
>65 yrs
(19%)
45–64 yrs
(30%)
<15
yrs
(6%)
15–24 yrs
(12%)
25–44 yrs
(32%)
Cases per 100,000
TB Case Rates by Age Group
and Sex, United States, 2007
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, 1993–2007**
50
40
30
20
10
0
1993
1995
1997
1999
2001
2003
2005
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 April 23, 2008.
2007
Cases per 100,000
TB Case Rates by Age Group and
Race/Ethnicity,* United States, 2007
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.
Reported TB Cases by Race/Ethnicity*
United States, 2007
American Indian or
White Alaska Native (1%)
(17%)
Native Hawaiian or
Other Pacific Islander
(<1%)
Hispanic or Latino
(29%)
Asian
(26%)
Black or
African-American
(26%)
*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, 1993–2007*
20000
15000
10000
5000
0
1993 1995 1997 1999 2001 2003 2005 2007
U.S.-born
*Updated as of April 23, 2008.
Foreign-born
Trends in TB Cases in Foreign-born
Persons, United States, 1987–2007*
No. of Cases
Percentage
10,000
70
60
50
40
30
20
10
0
8,000
6,000
4,000
2,000
0
1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007
No. of Cases
*Updated as of April 23, 2008.
Percentage of Total Cases
Reported TB Cases by Origin and
Race/Ethnicity,* United States, 2007
U.S.-born
Foreign-born**
American Indian
or Alaska Native
(3%)
Asian (2%)
White (33%)
Native Hawaiian/Other
Pacific Islander (<1%)
Hispanic or
Latino (17%)
White (5%)
Hispanic or
Latino (38%)
Asian (43%)
Black or African
American (45%)
Black or African
American (13%)
*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*
1997
2007
DC
DC
>50%
25%–49%
<25%
*Updated as of April 23, 2008.
Cases per 100,000
TB Case Rates in
U.S.-born vs. Foreign-born Persons
United States, 1993–2007*
40
30
20
10
0
1993
1995
1997
U.S. Overall
*Updated as of April 23, 2008.
1999
2001
U.S.-born
2003
2005
Foreign-born
2007
Cases per 100,000
TB Case Rates in
U.S.-born vs. Foreign-born Persons
United States,* 1993–2007**
100
10
1
1993
1995
1997
U.S. Overall
1999
2001
U.S.-born
2003
2005
Foreign-born
*Includes the same data as slide 15, but rates presented on a logarithmic scale.
**Updated as of April 23, 2008.
2007
Countries of Birth of Foreign-born
Persons Reported with TB
United States, 2007
Mexico
(24%)
Other
Countries
(39%)
Philippines
(12%)
Rep.
Korea
(3%) Haiti
(2%) China
(5%)
India
(8%)
Viet Nam
(7%)
Percent of Foreign-born with
TB by Time of Residence in
U.S. Prior to Diagnosis, 2007
100%
80%
60%
40%
20%
0%
All
Mexico
Missing*
<1 yr
Philippines
1–4 yrs
India
>5 yrs
* Foreign-born TB patients for whom information on length of
residence in the U.S. prior to diagnosis is unknown or missing.
Primary Anti-TB Drug Resistance
United States, 1993–2007*
% Resistant
10
5
0
1993
1995
1997
1999
Isoniazid
2001
2003
2005
MDR TB
*Updated as of April 23, 2008.
Note: Based on initial isolates from persons with no prior history of TB.
Multidrug resistant TB (MDR TB) is defined as resistance to at least
isoniazid and rifampin.
2007
Primary MDR TB
United States, 1993–2007*
No. of Cases
Percentage
500
400
300
200
100
0
3
2
1
0
1993
1995
1997
1999
No. of Cases
2001
2003
2005
Percentage
*Updated as of April 23, 2008.
Note: Based on initial isolates from persons with no prior history of TB.
MDR TB defined as resistance to at least isoniazid and rifampin.
2007
% Resistant
Primary Isoniazid Resistance in
U.S.-born vs. Foreign-born Persons
United States, 1993–2007*
14
12
10
8
6
4
2
0
1993
1995
1997
1999
U.S.-born
2001
2003
2005
Foreign-born
*Updated as of April 23, 2008.
Note: Based on initial isolates from persons with no prior history of TB.
2007
% Resistant
Primary MDR TB in
U.S.-born vs. Foreign-born Persons,
United States, 1993–2007*
3
2
1
0
1993
1995
1997
1999
U.S.-born
2001
2003
Foreign-born
*Updated as of April 23, 2008.
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
2007
XDR TB Case Count defined on
†
Initial DST by Year, 1993–2007*
12
Case Count
10
8
6
4
2
0
1993
1995
1997
1999
2001
2003
2005
Year of Diagnosis
†
Drug susceptibility test.
*Reported incident cases as of April 23, 2008.
Extensively drug-resistant TB (XDR TB) is defined as resistance to isoniazid and rifampin,
plus resistance to any fluoroquinolone and at least one of three injectable second-line anti-TB drugs.
2007
% with Test Results
Reporting of HIV Test Results
in Persons with TB by Age Group
United States, 1993–2006*
80
60
40
20
0
1993
1995
1997
All Ages
1999
2001
2003
Aged 25–44
*Updated as of April 23, 2008.
Note: Includes TB patients with positive, negative, or indeterminate HIV test
results. Persons from California reported with AIDS only through 2004.
(HIV test results are not reported from California)
2005
2006
% Coinfection
Estimated HIV Coinfection in Persons
Reported with TB, United States,
1993–2006*
30
20
10
0
1993
1995
1997
1999
All Ages
2001
2003
Aged 25–44
*Updated as of April 23, 2008.
Note: Minimum estimates based on reported HIV-positive status
among all TB cases in the age group.
2005
2006
Mode of Treatment Administration
in Persons Reported with TB
United States, 1993–2005*
100%
80%
60%
40%
20%
0%
1993
1995
1997
DOT only
1999
DOT + SA
2001
2003
SA only
*Updated as of April 23, 2008.
Directly observed therapy (DOT); Self-administered therapy (SA)
2005
Completion of TB Therapy
United States, 1993–2005*
Percentage
100
**
80
60
40
20
0
1993
1995
1997
Completed
1999
2001
2003
Completed in 1 yr or less
*Updated as of April 23, 2008.
**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.
2005