Tuberculosis Epidemiology Renai Edwards, MPH July 22, 2008

Transcription

1 TB Nurse Case Management Albuquerque, New Mexico July 22-23, 2008 Tuberculosis Epidemiology Renai Edwards, MPH July 22, 2008 Tuberculosis Epidemiology Renai Edwards, MPH Program Manager TB & Refugee Health Programs 1

2 Learning Objectives Describe current tuberculosis (TB) epidemiology 1. TB in the world 2. TB in the United States 3. TB in New Mexico and the Heartland Region 4. Identification of high-risk individuals & settings World TB Epidemiology Available online at: 2

3 TB A Worldwide Public Health Problem 2 billion people infected with TB 9 million new cases reported annually 2005: 15 million persons with TB disease 95% in developing nations Worldwide incidence: 136 cases/100,000 population Global TB incidence growing, especially in Africa 3 million deaths attributed to TB annually 98% in developing nations ¼ of all preventable deaths in developing world Leading infectious disease killer of adults worldwide Leading killer of HIV-infected people Estimated Numbers of New Cases, 2006 Estimated number of new TB cases (all forms) No estimate or more The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. WHO All rights reserved 3

4 Estimated TB Incidence Rates, 2006 Estimated new TB cases (all forms) per population No estimate or more The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. WHO All rights reserved Tuberculosis notification rates, 2006 Notified TB cases (new and relapse) per population No report or more The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. WHO All rights reserved 4

5 United States TB Epidemiology Available online at: TB Case Rates,* United States, 2006 D.C. *Cases per 100,000. < 3.5 (year 2000 target) > 4.6 (national average) 5

6 TB Case Rates by Age Group and Sex, United States, 2006 Cases per 100, <15 yrs yrs yrs yrs >65 yrs Male Female Cases per 100, TB Case Rates by Race/Ethnicity* United States, ** Asian/Pacific Islander Black or African-American Hispanic American Indian/Alaska Native 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 6,

7 Percentage of TB Cases Among Foreign-born Persons, United States* DC DC >50% 25% 49% <25% *Updated as of April 6, Centers for Disease Control & Prevention Heartland Region TB Epidemiology Available online at: 7

8 TB Cases and Case Rates per 100,000 population, Heartland Region State Number of Cases Case Rate Arizona Illinois Iowa Kansas Minnesota Missouri Nebraska New Mexico North Dakota Oklahoma South Dakota Texas Wisconsin United States 13, Heartland Region Case Rates, 2006 Wisconsin Iowa North Dakota Nebraska South Dakota Missouri New Mexico Kansas Oklahoma Minnesota Illinois United States Arizona Texas High Incidence Mid Incidence Low Incidence 8

9 New Mexico TB Epidemiology New Mexico, Number Active TB Cases (Jan- Year Jun) 9

10 TB Case Rates per 100,000 U.S. and New Mexico, Rate United States New Mexico Year NM TB Cases by Age and Gender, Number Female Male Total Age 10

11 "Race and Ethnicity Proportion of Cases per Population, NM, Percent Cases Population American Indian/Alaskan Native Asian Black White Hispanic, any race Race & Ethnicity Foreign-Born TB Cases, NM, 2007 Percent Foreign-Born Number of Cases by Geographic Area 47% 53% US-Born Foreign-Born Mexico Asia Central America Sub-Saharan Africa 11

12 Population Risks for TB, New Mexico and United States NM (2007) US (2006) Risk Factor % % Unemployed, past 24 months Homeless 10 6 Excess Alcohol Use, past year Injection drug use, past year 2 2 Non-injection drug use, past year 6 8 Resident of a correctional facility at Dx 4 4 Resident of a long-term care facility 0 2 HIV co-infection <1 --- Resistance to Anti-TB Drugs, NM, Number of Cases Mono- Resistant* Multi-Drug Resistant** Year * Defined as resistance to either Isoniazid or Rifampin; ** Defined as resistance to both Isoniazid and Rifampin 12

13 Completion of TB Therapy within 12 Months, NM, Percent Goal Completion Rate Year Common Reasons for Treatment (Tx) >12 months Missed doses that cause Tx to be extended Patient feels better & decides to stop Tx Lost to follow-up Deported Moved 13

14 New Mexico Health Regions State of New Mexico 2007 Tuberculosis Cases and Case Rates by County and Public Health Region County Population* TB Cases Case Rate (per 100,000 population) Region I 419, Cibola 28, McKinley 79, San Juan 127, Sandoval 111, Valencia 71, Region II 303, Colfax 14, Guadalupe 4, Los Alamos 19, Mora 5, Rio Arriba 43, San Miguel 30, Santa Fe 147, Taos 32, Union 4,

15 State of New Mexico 2007 Tuberculosis Cases and Case Rates by County and Public Health Region County Population* TB Cases Case Rate (per 100,000 population) Region III 628, Bernalillo 628, Region IV 252, Chaves 63, Curry 46, De Baca 2, Eddy 52, Harding Lea 58, Quay 10, Roosevelt 18, State of New Mexico 2007 Tuberculosis Cases and Case Rates by County and Public Health Region County Population* TB Cases Case Rate (per 100,000 population) Region V 407, Catron 3, Dona Ana 198, Grant 31, Hidalgo 5, Lincoln 22, Luna 27, Otero 66, Sierra 13, Socorro 18, Torrance 18, NM Total 2,010, US Total 299,398,484 13,779** 4.60** *Source: Bureau of Business and Economic Research, University of New Mexico, effective date: 10/02/07. **Source: CDC, Reported Tuberculosis in the United States, 2006, September

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