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Tuberculosis in the United States
National Tuberculosis Surveillance System
Highlights from 2011
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB PreventionDivision of Tuberculosis Elimination
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Reported TB Cases United States, 1982–2011*
*Updated as of June 25, 2012.
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
0
5,000
10,000
15,000
20,000
25,000
30,000
No. o
f Cas
es
Year
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Year No. Rate*2006 13,727 4.6
2007 13,278 4.4
2008 12,895 4.2
2009 11,528 3.8
2010 11,171 3.6
2011 10,528 3.4
*Cases per 100,000. Updated as of June 25, 2012.
TB MorbidityUnited States, 2006–2011
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TB Case Rates,* United States, 2011
*Cases per 100,000.
< 3.4 (2011 national average)>3.4
D.C.
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TB Case Rates* by Age Group United States, 1993–2011
* Updated as of June 25, 2012.
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
0.0
5.0
10.0
15.0
20.0
0- 14 15 - 24 25 - 44 45-65
Cas
es p
er 1
00,0
00
Age Group (years)
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Reported TB Cases by Age Group, United States, 2011
<15 yrs (5%) 15-24 yrs
(10%)
24-44 yrs (32%)45-64 yrs
(31%)
≥ 65 yrs(21%)
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TB Case Rates by Age Group and Sex, United States, 2011
Under 5 5 - 14 15 - 24 24 - 44 45-64 ≥650.01.02.03.04.05.06.07.08.0
Male Female
Cas
es p
er 1
00,0
00
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TB Case Rates by Race/Ethnicity* United States, 2003–2011**
*All races are non-Hispanic. **Updated as of June 25, 2012.
Cas
es p
er 1
00,0
00
2003 2004 2005 2006 2007 2008 2009 2010 20110.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
Hispanic or Latino American Indian or Alaska Native Asian
Black or African American Native Hawaiian or Other Pacific Islander White
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TB Case Rates by Age Group and Race/Ethnicity* United States, 2011
*All races are non-Hispanic. Persons reporting two or more races accounted for less than 1% of all cases.
Under 5 5 - 14 15 - 24 24 - 44 45-64 ≥650.0
10.0
20.0
30.0
40.0
50.0
60.0
Hispanic or Latino American Indian or Alaska Native AsianBlack or African American Native Hawaiian or Other Pacific Islander White
Cas
es p
er 1
00,0
00
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Reported TB Cases by Race/Ethnicity*United States, 2011
*All races are non-Hispanic. Persons reporting two or more races accounted for less than 1% of all cases.
Hispanic or Latino(29%)
Native Hawaiian or Other Pacific Is-
lander(1%)
White(16%)Asian
(30%)
American Indian or Alaska Native
(1%)
Black or African American
(23%)
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Number of TB Cases inU.S.-born vs. Foreign-born Persons
United States, 1993–2011*
1993
1995
1997
1999
2001
2003
2005
2007
2009
2011
0
5,000
10,000
15,000
20,000
U.S.-born Foreign-born
*Updated as of June 25, 2012.
No. o
f Cas
es
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Trends in TB Cases in Foreign-born Persons
United States, 1991 – 2011*
*Updated as of June 25, 2012.
No. of Cases Percentage
19911992
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20110
1,0002,0003,0004,0005,0006,0007,0008,0009,000
10,000
0
10
20
30
40
50
60
70
Number of Cases Percentage of Total Cases
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Reported TB Cases by Origin and Race/Ethnicity,* United States, 2011
*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.
Hispanic or Latino
(19%)American Indian or Alaska Native(3%)
Asian(3%)
Black or African American
(39%)
Native Hawaiian or Other Pacific Is-
lander(2%)
White(33%)
His-panic or Latino(34%)
Asian(46%)
Black or African Ameri-
can(13%)
White(5%)
U.S.-born Foreign-born**
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>50%25%–49%<25%
2001 2011
DC
*Updated as of June 25, 2012.
Percentage of TB Cases Among Foreign-born Persons, United States*
DC
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TB Case Rates in U.S.-born vs. Foreign-born Persons, United States, 1993 –
2011*
*Updated as of June 25, 2012.
Cas
es p
er 1
00,0
00
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20110.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
U.S. Overall U.S.-born Foreign-born
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TB Case Rates in U.S.-born vs. Foreign-born Persons, United States*, 1993 –
2011**
*Includes the same data as slide 15, but rates presented on a logarithmic scale.**Updated as of June 25, 2012.
Cas
es p
er 1
00,0
00
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20111.0
10.0
100.0
U.S. Overall U.S.-born Foreign-born
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Countries of Birth of Foreign-born Persons Reported with TB, United
States, 2011
Mexico(22%)
Philippines(11%)
India(8%)
Vietnam(8%)China
(6%)Guatemala
(3%)
Haiti(3%)
Other Countries39%
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Percent of Foreign-born with TB by Time of Residence in U.S. Prior to
Diagnosis, 2011
*Foreign-born TB patients for whom information on length of residence in the U.S. prior to diagnosis is unknown or missing
Mexico Philippines Vietnam All Foreign-born0
102030405060708090
100
Unknown* <1 year 1-4 years ≥5 years
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Primary Anti-TB Drug ResistanceUnited States, 1993 – 2011*
*Updated as of June 25, 2012.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
% R
esist
ant
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20110123456789
10
Isoniazid MDR TB
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Primary MDR TBUnited States, 1993 – 2011*
*Updated as of June 25, 2012.Note: Based on initial isolates from persons with no prior history of TB. MDR TB defined as resistance to at least isoniazid and rifampin.
No. of Cases Percentage
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20110
100
200
300
400
500
0
1
2
3
No. of Cases Percentage
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Primary Isoniazid Resistance in U.S.-born vs. Foreign-born Persons
United States, 1993 – 2011*
*Updated as of June 25, 2012.Note: Based on initial isolates from persons with no prior history of TB.
% R
esist
ant
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20110
2
4
6
8
10
12
14
U.S.-born Foreign-born
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*Updated as of June 25, 2012.Note: Based on initial isolates from persons with no prior history of TB. MDR TB defined as resistance to at least isoniazid and rifampin.
Primary MDR TB in U.S.-born vs. Foreign-born Persons
United States, 1993 – 2011*
% R
esist
ant
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20110
1
2
3
U.S.-born Foreign-born
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XDR TB Case Count Defined on Initial DST*
by Year, 1993 – 2011**
* Drug susceptibility test** Updated as of June 25, 2012.Note: 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
Case
Cou
nt
Year of Diagnosis1993
19941995
19961997
19981999
20002001
20022003
20042005
20062007
20082009
20102011
0
2
4
6
8
10
12
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Reporting of HIV Test Results in Persons with TB by Age Group
United States, 1993 – 2011*
*Updated as of June 25, 2012.Note: Includes TB patients with positive, negative, or indeterminate HIV test results. HIV test results not reported from California after 2004. HIV test results not reported from Rhode Island for years 1993-1997. HIV test results not reported from Vermont after 2007.
% w
ith Te
st R
esul
ts
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20110
10 20 30 40 50 60 70 80 90
100
All Ages Aged 25 - 44
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Estimated HIV Coinfection in Persons Reported with TB, United States, 1993 –
2011*
*Updated as of June 25, 2012Note: Minimum estimates based on reported HIV-positive status among all TB cases in the age group
% C
oinf
ectio
n
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20110
5
10
15
20
25
30
Aged 25-44 All Ages
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TB Cases by Residence in Correctional Facilities, Age ≥15, United States,
1993-2011*
*Updated as of June 25, 2012Note: Resident of correctional facility at time of TB diagnosis
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20110
200
400
600
800
1000
1200
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
No. of Cases Percent of Total Cases
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TB Cases Reported as Homeless in the 12 Months Prior to Diagnosis,
Age ≥15, United States, 1993-2011*
*Updated as of June 25, 2012Note: Homeless within past 12 months of TB diagnosis
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20110
200
400
600
800
1000
1200
1400
1600
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
No. of Cases Percent of Total Cases
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Mode of Treatment Administration in Persons Reported with TBUnited States, 1993 – 2009*
*Updated as of June 25, 2012. Data available through 2009 only.**Percentage of total cases in persons alive at diagnosis, with an initial regimen of one or more drugs prescribed, and excluding cases with unknown mode of treatment administration.Directly observed therapy (DOT); Self-administered therapy (SA)
Perc
enta
ge**
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20090
20
40
60
80
100
DOT only DOT + SA SA only
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Completion of TB TherapyUnited States, 1993 – 2009*
* Updated as of June 25, 2012. Data available through 2009 only.Note: Includes persons alive at diagnosis, with initial drug regimen of one or more drugs prescribed, who did not die during therapy. Excludes persons with initial isolate rifampin resistant, or patient with meningeal disease, or pediatric patient (aged <15) with miliary disease or positive blood culture.
Perc
enta
ge
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20090
20
40
60
80
100
Completed Completed in 1 year or less