TUBERCULOSIS: USA: Washington State statistics

Nov 26, 2011King County continues to have one of the highest tuberculosis (TB) infection rates in the United States, because of the world-wide epidemic and the region’s status as a global crossroads. Public Health - Seattle & King County’s new 2010 TB report—online at www.kingcounty.gov/health/tb—details these latest findings, its work in controlling the spread of the disease, and the ongoing and expensive challenge of battling drug resistant strains of TB.

In 2010, Public Health’s TB Program identified 114 cases of active TB and provided treatment and/or evaluation to more than 1,100 King County residents with active or latent TB. Nearly one in five people treated for active TB in King County are resistant to at least one medication, and two people had multi-drug resistant infections. The costs of treating multi-drug resistant TB can add up to $250,000 for each case. Further, approximately 100,000—or about five percent of people in King County—have latent TB infection. Globally, about two million die from TB every year, and one third of the population is infected.
“TB control is an essential investment in the health of our communities that helps us fight the local effects of this global disease,” said Dr. David Fleming, Director & Health Officer for Public Health – Seattle & King County. “In these difficult budget times, state funding support for this work is now threatened, but we can’t afford to let down our guard.”
Public health funding has experienced drastic cuts over the last few years, and potential cuts in Olympia further threaten core services, including TB control.
In addition to diagnosing and treating people with active TB, the TB Control Program also screens the family, friends and close contacts of people with active TB. In 2010, the TB Program tested more than 450 close contacts of people with active TB and found that nearly one-quarter were infected with latent (or dormant) TB.
“If we catch TB infection before it becomes active, treatment is cheaper and easier,” said Dr. Masa Narita, TB Control Officer for Public Health. “Best of all, fewer people will get sick with active tuberculosis.”
Additional findings in the 2010 TB Annual Report include:
King County’s infection rate, at 5.9 residents per 100,000, was one and one half times the United States rate of 3.6 per 100,000, and the Washington state rate of 3.5.
People of color continue to have disproportionately high rates of TB.
84 percent of infected individuals were born outside of the U.S., primarily Southeast Asia and India, East Africa and Central America.

Background on TB
Tuberculosis, also called TB, is an infectious disease caused by a bacterium named Mycobacterium tuberculosis. TB often involves the lungs (pulmonary TB) but can infect almost any organ in the body. TB is almost always curable with antibiotics that are readily available in countries such as the United States.
People with active TB disease are made sick by bacteria that are active in their body. People with latent, or dormant, TB infection are not sick because the germ is inactive inside their body, and they cannot spread TB infection to others.

To view the 2010 summary data and for more information on Public Health's TB Control Program and activities, visit: www.kingcounty.gov/health/tb.

http://www.maplevalleyreporter.com/news/134541278.html

TUBERCULOSIS: Patients with diabetes at high risk for developing tuberculosis

June 3, 2011
Restrepo BI. Bull World Health Organ. 2011;89:352-359.

The risk for contracting tuberculosis is three to five times higher for patients with diabetes compared with those without the disease, according to researchers at the University of Texas Health Science Center at Houston.
“With diabetes on the rise in [tuberculosis]-endemic areas, our findings highlight the re-emerging impact of diabetes … on [tuberculosis] control in regions of the world where both diseases are prevalent,” the researchers wrote in their study.
Blanca Restrepo, PhD, associate professor of epidemiology at University of Texas School of Public Health, Brownsville Regional Campus, and colleagues enrolled 233 patients with probable tuberculosis (TB) between March 2006 and September 2008 at TB clinics in South Texas and northeastern Mexico. The purpose of the study was to estimate the risk for TB attributable to diabetes in those living along the Mexican border. They used primary data from patients with newly diagnosed TB who were tested for diabetes, according to the study.
The prevalence of diabetes was higher among patients with TB vs. the general population in South Texas (39.3% vs. 19.5%) and northeastern Mexico (36% vs. 15.1%). The researchers estimated that patients with diabetes had three times the risk for developing TB compared with those without diabetes, and that risk was five times higher for those aged 35 to 64 years. In patients aged at least 20 years, the estimated fraction of TB cases attributable to diabetes was 26% in South Texas and 24% in northeastern Mexico. The rate increased to 48% among people aged between 35 and 64 years living in South Texas. Across the population, the fraction of TB cases attributable to diabetes was 63% in South Texas and 68% in northeastern Mexico.
According to the researchers, almost all of the patients with diabetes were aware of their diabetes disease status at least 6 months before TB diagnosis.
“These findings reveal that diabetic patients with TB are not new to the health care system and highlight the fact that opportunities for preventing TB among diabetes patients are often missed,” the researchers wrote. “While not all diabetes patients with latent TB infection should take prophylactic treatment, such patients should be made aware of their risk of TB and should discuss with their physicians the potential risks and benefits of taking preventive anti-TB treatment.”
http://www.endocrinetoday.com/view.aspx?rid=84310

TUBERCULOSIS: More Progress Needed To Prevent Urban Tuberculosis In The U.S.

12 May 2011 : Eyal Oren, Tuberculosis Control Program
"Epidemiology of Urban Tuberculosis in the United States, 2000-2007."


A new study from the American Journal of Public Health finds a significant TB burden in large U.S. cities. Researchers investigated tuberculosis incidence rates and characteristics of patients with TB in large U.S. cities. They categorized 48 cities annually from 2000 to 2007 as reporting decreasing or non-decreasing rates with the data from the Centers for Disease Control and Prevention's National Tuberculosis Surveillance System.
They compared demographic, clinical and treatment characteristics of patients with TB. They found that 42,448 patients with TB in 48 cities accounted for 36 percent of all U.S. patients with TB, comprising 15 percent of the total U.S. population. Researchers also discovered that 29 of the 48 cities showed no significant change in TB incidence over the course of the study, which raises concerns for the elimination of TB.
The study's authors wrote, "Our study illustrates the need to address the continuing challenges of urban TB control and highlights some of the factors contributing to variability of TB trends among cities. It is important to detail how specific characteristics of the urban environment shape health and how observations may extend to different urban contexts."
http://www.medicalnewstoday.com/releases/225102.php

TUBERCULOSIS: USA: More Progress Needed To Prevent Urban Tuberculosis

12 May 2011
A new study from the American Journal of Public Health finds a significant TB burden in large U.S. cities. Researchers investigated tuberculosis incidence rates and characteristics of patients with TB in large U.S. cities. They categorized 48 cities annually from 2000 to 2007 as reporting decreasing or non-decreasing rates with the data from the Centers for Disease Control and Prevention's National Tuberculosis Surveillance System.
They compared demographic, clinical and treatment characteristics of patients with TB. They found that 42,448 patients with TB in 48 cities accounted for 36 percent of all U.S. patients with TB, comprising 15 percent of the total U.S. population. Researchers also discovered that 29 of the 48 cities showed no significant change in TB incidence over the course of the study, which raises concerns for the elimination of TB.
The study's authors wrote, "Our study illustrates the need to address the continuing challenges of urban TB control and highlights some of the factors contributing to variability of TB trends among cities. It is important to detail how specific characteristics of the urban environment shape health and how observations may extend to different urban contexts."
http://www.medicalnewstoday.com/releases/225102.php

TUBERCULOSIS: USA: decreasing, but rate of decline slows

 Charles C. Chante, MD  May 01, 2011

The tuberculosis in the United States continues to decline, has slowed since 2000 and the rate of infection among racial/ethnic minorities and foreign-born individuals continues to be disproportionately high.
Those were among the findings of a report on 2008 US trends in tuberculosis published by the Centers for Disease Control and Prevention.
In 2008, a total of 12,898 incident TB cases were reported in the United States. Representing a decline of 3.8 percent from 2007 and a rate of 4.2 per 100,000 population.
The 2008 rate was the lowest recorded since TB reporting began in 1953.
Progress has slowed in recent years, however, with the average annual percentage decline in the TB rate decreasing from 7.3 percent per year during 1993-2000 to 3.8 percent during 2000-2008.
Among the 50 states and the District of Columbia, TB rates ranged from a low of 0.5/100,000 in North Dakota to a high of 9.6/100,000 in Hawaii.
California, Florida, New York, and Texas reported more than 500 cases each and together accounted for 49 percent of all TB cases in 2008.
TB rates among Hispanics and blacks were nearly eight times higher than among non-Hispanic whites (8.1 and 8.7 per 100,000, respectively, versus 1.1 per 100,000), while the rate among Asians was nearly 23 times higher than among non-Hispanic whites (25.1 per 100,000).
The report classified persons identified as white, black, Asian, American Indian/Alaska Native, native Hawaiian or other Pacific Islanders or of multiple races, as non-Hispanic. “Persons identified as Hispanic might be of any race,” the report explained.
The 2008 TB rate in foreign-born persons living in the United States was 20.2 per 100,000, 10 times higher than for US-born individuals. People born in Mexico, the Philippines, India, and Vietnam accounted for half of the 7,541 tuberculosis cases in foreign-born persons that year.
However, the rate of TB cases, continued to decline both among foreign-born individuals (down 2.6 percent since 2007), as well as those born in the United States (down 4.7 percent).
Based on the data, the CDC recommended that TB prevention and control capacity be intensified to improve case management and contact investigations. The agency also called for intensified outreach, testing, and treatment of high risk populations; enhanced treatment and diagnostic tools; increased scientific research to be better understand TB transmission; and continued collaboration with other nations to reduce TB globally.
http://www.philstar.com/Article.aspx?articleId=681278&publicationSubCategoryId=64