Chapter 1 Overview of Tuberculosis Epidemiology in the United States
|
|
- Alexis Bruce
- 1 years ago
- Views:
Transcription
1 Chapter 1 Overview of Tuberculosis Epidemiology in the United States Table of Contents Chapter Objectives Progress Toward TB Elimination in the United States... 3 TB Disease Trends in the United States, Chapter Summary References Chapter Objectives After working through this chapter, you should be able to Discuss progress toward tuberculosis (TB) elimination in the United States; Identify TB disease trends in the United States; and List the racial and ethnic groups that are disproportionately affected by TB disease in the United States. 1
2
3 Progress Toward TB Elimination in the United States In 1989, the Centers for Disease Control and Prevention (CDC) announced the goal of eliminating TB from the United States by the year A Strategic Plan for the Elimination of Tuberculosis in the United States was published in 1989 and reassessed in 1999 to identify the actions necessary to achieve elimination. The achievement of this goal was thwarted by the TB resurgence that occurred in the late 1980s and early 1990s. This resurgence was fueled by the following factors: The onset of the human immunodeficiency virus (HIV) epidemic; Increases in immigration of persons from countries where TB disease was common; TB transmission in congregate settings; and The development of multidrug-resistant (MDR) TB. These factors occurred at a time when decades of cuts in funding had resulted in inadequate support for TB control and other public health efforts, and in the deterioration of TB control programs. As a result, federal, state, and local TB control offcials had very few resources for TB control activities. Subsequently, the United States renewed its commitment to TB control in the 1990s and mobilized new resources. In 1993, the upward trend of new TB cases reversed, and the number of new cases has continued its decline up to and through This can be attributed to the increase in funds and resources which enabled TB programs to improve their control efforts to Promptly identify persons with TB disease; Start appropriate treatment for persons with TB disease; and Ensure patients complete treatment. Despite unprecedented low rates of TB disease, elimination of TB faces some major barriers including TB disease in high-risk populations where it is diffcult to detect, diagnose, and treat; Persistence and growth of the global TB epidemic; and Limitations of current control measures and the need for new tests and treatments, including an effective vaccine. 3
4 TB Disease Trends in the United States, The resurgence of TB disease, which began in the mid-1980s, was marked by several years of increasing case counts until its peak in Case counts began decreasing in 1993, and 2009 marked the seventeenth year of decline in the total number of TB cases reported in the United States since the peak of the resurgence (Figure 1.1). From 1993 until 2002, the total number of TB cases decreased 5% 7% annually. Although rates continued to decline from 2003 through 2008, it was at a much slower rate. In 2009, a total of 11,545 cases were reported from the 50 states and the District of Columbia (D.C.). This represents a decline of 10.5% from 2008 (Table 1.1). 1RRI&DVHV Fig 1.1 Reported TB Cases* United States, <HDU 8SGDWHGDVRI-XO\ 4
5 Table 1.1 TB Morbidity United States, Year No. Rate* , , , , , , , *Cases per 100,000, updated as of July 1, While national trends indicate that there has been a decline in the overall number of cases since 1993, cases continue to be reported. It is important to focus on local epidemiology to identify trends in individual states or regions. While national trends indicate that there has been a decline in the overall number of cases since 1993, cases continue to be reported. For the decade leading up to 2009, a group of 34 states has had an annual rate no greater than 3.5 TB cases per 100,000, a rate that was chosen to be the target for the year Four states (California, Texas, New York, and Florida) accounted for 50% of the TB cases in the United States in 2009 (Figure 1.2). 5
6 Figure 1.2 TB Case Rates* United States, 2009 '& &DVHVSHU TB Case Rates by Origin \HDUWDUJHW ±!QDWLRQDODYHUDJH During 1993 to 2003, rates declined in both the U.S.-born and the foreign-born populations; however, the decline was substantially less among foreign-born populations. In 2002, for the first time, TB cases among foreign-born persons accounted for the majority (51.2%) of TB cases in the United States. Overall, the number of cases in foreign-born persons has remained virtually level with approximately 7,000-8,000 cases each year, until 2009 when the number dropped to 6,854. The number of cases in U.S.-born persons decreased from more than 17,000 in 1993 to 4,571 in In 2002, for the first time, TB cases among foreign-born persons accounted for the majority (51.2%) of TB cases in the United States. 6
7 Percentage of TB Cases among Foreign-Born Persons in the United States, The percentage range of the total number of TB cases that occurred in foreign-born persons in each state is highlighted for 1999 and 2009 in side-by-side maps (Figure 1.3). The number of states with at least 50% of cases in foreign-born persons increased from 13 states in 1999 to 31 states in The number of states with at least 70% of cases in foreign-born persons increased from 2 (Hawaii and Minnesota) in 1999 to 14 in Figure 1.3 Percentage of TB Cases Among Foreign-Born Persons United States* 8SGDWHGDVRI-XO\ '&! ± The countries of birth of foreign-born persons reported with TB disease in the United States have remained relatively constant since Seven countries accounted for 62% of the total in 2009 (Table 1.2 and Figure 1.4). In 1999, foreign-born persons made up 43% of all cases; however, by 2009, this had increased to 59%. '& 7
8 Table 1.2 Countries of Birth of Foreign-Born Persons Reported with TB in the United States, 2009 Country Percent of Total Cases in the United States Mexico 23% Philippines 12% India 8% Vietnam 8% China 5% Guatemala 3% Haiti 3% Other Countries (135) 38% Figure 1.4 Countries of Birth of Foreign-Born Persons Reported with TB United States,
9 Race and Ethnicity The trend in TB rates by race/ethnicity in the United States for indicates that Asians and Pacific Islanders had the highest TB rates, with a rate of 41.2 per 100,000 beginning in 1993 and declining to 23.1 in Asians and Pacific Islanders also had the smallest percentage decline over the same time period (43%). Rates declined by at least 65% over the same time period in the other racial/ethnic groups, including non-hispanic blacks or African Americans, Hispanics, American Indians and Alaska Natives, and non-hispanic whites (Figure 1.5). &DVHVSHU Figure 1.5 TB Case Rates by Race/Ethnicity* United States, ** $VLDQ3DFLILF,VODQGHU %ODFNRU$IULFDQ$PHULFDQ +LVSDQLF $PHULFDQ,QGLDQ$ODVND1DWLYH :KLWH $OOUDFHVDUHQRQ+LVSDQLF,Q$VLDQ3DFLILF,VODQGHUFDWHJRU\LQFOXGHVSHUVRQV ZKRUHSRUWHGUDFHDV$VLDQRQO\DQGRU1DWLYH+DZDLLDQRU2WKHU3DFLILF,VODQGHURQO\ 8SGDWHGDVRI-XO\ Several important factors contribute to the disproportionate burden of TB disease in minorities, including the following: Infection acquired in the country of origin in foreign-born minorities; Unequal distribution of TB risk factors, contributing to increased exposure to TB or to an increased risk of developing TB disease once infected; Lower socioeconomic status and the effects of crowding. 9
10 HIV-Infected Persons HIV-infected persons are at high risk for developing TB disease after infection with M. tuberculosis. In 1993, the percentage of HIV coinfection in all ages of persons reported with TB disease was 15%, decreasing to 6% in In the age group of persons 25 44, it fell from a high of 29% in 1993 to 10% in 2009 (Figure 1.6). Figure 1.6 Estimated HIV Coinfection in Persons Reported with TB United States, * &RLQIHFWLRQ $JHG 8SGDWHGDVRI-XO\ 1RWH0LQLPXPHVWLPDWHVEDVHGRQUHSRUWHG+,9SRVLWLYHVWDWXV DPRQJDOO7%FDVHVLQWKHDJHJURXS $OO$JHV HIV-infected persons are at high risk for developing TB disease after infection with M. tuberculosis.
11 Multidrug-Resistant TB Multidrug-resistant TB (MDR TB) is caused by an organism that is resistant to at least isoniazid and rifampin, the two most potent TB drugs; it is a serious public health concern. Both U.S.-born and foreign-born persons had decreases in the number and percentage of cases of MDR TB, although the decline in U.S.-born persons has been greater. As a result, the percentage of all primary MDR TB cases reported and associated with being foreign born increased from approximately 25% of all MDR TB cases in 1993 to 88% in 2009 (Figure 1.7). Figure 1.7 Primary MDR TB in U.S.-Born vs. Foreign-Born Persons United States, * 5HVLVWDQW 86ERUQ )RUHLJQERUQ 8SGDWHGDVRI-XO\ 1RWH%DVHGRQLQLWLDOLVRODWHVIURPSHUVRQVZLWKQRSULRUKLVWRU\RI7% 0'57%GHILQHGDVUHVLVWDQFHWRDWOHDVWLVRQLD]LGDQGULIDPSLQ Primary MDR TB cases reported in foreign-born persons increased from approximately 25% of all MDR cases in 1993 to 88% in
12 Extensively Drug-Resistant TB Extensively drug-resistant TB (XDR TB) is a rare type of MDR TB that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin). For , the annual numbers of reported XDR TB cases, as determined by the initial drug-susceptibility test (DST), are shown below (Figure 1.8). There is no apparent trend in the number of XDR TB cases over time in the United States. The greatest number of cases reported in a single year that met the XDR TB case definition was 10 in There were no cases reported in 2003 or &DVH&RXQW There is no apparent trend in the number of XDR TB cases over time in the United States. Figure 1.8 XDR TB Case Count Determined by the Initial DST by Year * <HDURI'LDJQRVLV 'UXJVXVFHSWLELOLW\WHVW 5HSRUWHGLQFLGHQWFDVHVDVRI -XO\ ([WHQVLYHO\GUXJUHVLVWDQW7%;'57%LVGHILQHGDVUHVLVWDQFHWRLVRQLD]LGDQGULIDPSLQ SOXVUHVLVWDQFHWRDQ\IOXRURTXLQRORQHDQGDWOHDVWRQHRIWKUHHLQMHFWDEOHVHFRQGOLQH DQWL7%GUXJV The decrease in TB and MDR TB is encouraging; however, the earlier resurgence of TB provides a valuable lesson. Every TB case is a potential outbreak. Health departments must be prepared to identify promptly and treat persons who have active TB disease, as well as identify and treat close contacts who may have become infected from persons with active TB disease. By understanding which groups are at higher risk for becoming infected with M. tuberculosis, health departments can better focus TB prevention and control efforts (Table 1.3). 12
13 Table 1.3 Persons at Higher Risk for Exposure to and/or Infection with M. tuberculosis Description Close contacts of persons known or suspected to have active TB disease Foreign-born persons from areas that have a high incidence of active TB disease (e.g., Africa, Asia, Eastern Europe, Latin America, and Russia) Persons who visit areas with a high prevalence of TB disease, especially if visits are frequent or prolonged Residents and employees of high-risk congregate settings (e.g., correctional facilities, long-term care facilities, and homeless shelters) Health-care workers who serve clients who are at increased risk for active TB disease Populations defined locally as having an increased incidence of latent M. tuberculosis infection or active TB disease, possibly including medically underserved, low-income populations, or persons who abuse drugs or alcohol Infants, children, and adolescents exposed to adults who are at increased risk for latent tuberculosis infection or active TB disease Study Questions 1.1 In 2009, how many TB cases were reported from the 50 states and D.C.? (circle the one best answer) A. 5,466 B. 11,545 C. 21, Which of the following statements is true about TB case rates between 1993 and 2009? (circle the one best answer) A. Rates increased in both foreign-born populations and U.S.-born populations. B. Rates decreased in both foreign-born populations and U.S.-born populations. C. Rates remained level in both foreign-born populations and U.S.-born populations. Chapter 1: Overview of Tuberculosis Epidemiology in the United States 13
14 The following countries of birth of foreign-born persons accounted for 62% of the total number of TB cases in the United States in Match the country of birth with its percentage of total TB cases among foreign-born persons. (Choose the one best answer and write the letter for the correct answer on the line next to the question number.) 1.3 China Country of Birth 1.4 Guatemala 1.5 Haiti 1.6 India 1.7 Mexico 1.8 Philippines 1.9 Vietnam Percent of Total TB Cases in the United States, 2009 (Answers may be used more than once) A. 3% B. 5% C. 8% D. 12% E. 23% 1.10 Which of the following statements about trends in TB rates by race/ethnicity in the United States, from 1993 to 2009, are true? (circle the one best answer) A. Rates declined among Asians and Pacific Islanders from 41.2 per 100,000 in 1993 to 23.1 in B. Rates declined by at least 65% among non-hispanic blacks or African Americans, Hispanics, American Indians and Alaska Natives, and non-hispanic whites from 1993 to C. Rates increased among Hispanics, from 8.1 per 100,000 in 1993 to 19.9 in D. A, B, and C are all correct. E. Only A and B are correct. Chapter 1: Overview of Tuberculosis Epidemiology in the United States 14
15 1.11 Which of the following factors contribute to the disproportionate burden of TB disease in minorities? (circle the one best answer) A. Infection acquired in the country of origin in foreign-born minorities. B. Unequal distribution of TB risk factors, contributing to increased exposure to TB disease or to an increased risk of developing TB disease once infected. C. Lower socioeconomic status and the effects of crowding. D. A, B, and C are all correct. E. Only A and B are correct Which of the following statements about MDR TB and XDR TB in the United States are true? (circle the one best answer) A. Primary MDR TB cases reported in foreign-born persons increased from approximately 25% among all MDR TB cases in 1993 to 88% in B. There is no apparent trend in the number of XDR TB cases over time in the United States. C. The annual number of cases of counted XDR TB cases during was 154. D. A, B, and C are correct. E. Only A and B are correct Of the following persons, who is LEAST likely to be exposed to TB disease? (circle the one best answer) A. Trang was born in Vietnam and recently immigrated to the United States. B. Frank lives in a homeless shelter. C. Joshua attends high school in Canton, Ohio. D. Ellen is a nurse at the Texas State Penitentiary at Huntsville. Chapter 1: Overview of Tuberculosis Epidemiology in the United States 15
16 Chapter Summary The resurgence of TB disease, which began in the mid-1980s, was marked by several years of increasing case counts until its peak in Case counts began decreasing in 1993, and 2009 marked the seventeenth year of decline in the total number of TB cases reported in the United States since the peak of the resurgence. From 1993 until 2002, the total number of TB cases decreased 5% 7% annually. Although rates continued to decline from 2003 through 2008, it was at a much slower rate. In 2009, a total of 11,545 cases were reported from the 50 states and D.C. This represents a decline of 10.5% from HIV-infected persons are at high risk for developing TB disease after infection with M. tuberculosis. In 1993, the percentage of HIV coinfection in all ages of persons reported with TB disease was 15%, decreasing to 6% in In the age group of persons 25 44, HIV coinfection fell from a high of 29% in 1993 to 10% in MDR TB is caused by an organism that is resistant to at least isoniazid and rifampin, the two most potent TB drugs; it is a serious public health concern. Both U.S.-born and foreign-born persons had decreases in the number and percentage of cases of MDR TB, although the decline in U.S.-born persons has been greater. As a result, the percentage of all primary MDR TB cases reported and associated with being foreign-born increased from approximately 25% of all MDR TB cases in 1993 to 88% in There is no apparent trend in the number of XDR TB cases over time in the United States. The greatest number of cases reported in a single year that met XDR TB case definition was 10 in There were no cases reported in 2003 or References CDC. A strategic plan for the elimination of tuberculosis in the United States. MMWR 1989; 38 (Suppl No. S-3). CDC. CDC s Response to Ending Neglect: The Elimination of Tuberculosis in the United States. Atlanta, Ga: U.S. Department of Health and Human Services, CDC; CDC. Controlling tuberculosis in the United States: Recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMWR 2005; 54 (No. RR-12). CDC. Essential components of a tuberculosis prevention and control program: Recommendations of the Advisory Council for the Elimination of Tuberculosis. MMWR 1995; 44 (No. RR-11). CDC. Extensively drug-resistant tuberculosis United States, MMWR 2007; 56 (11): Chapter 1: Overview of Tuberculosis Epidemiology in the United States 16
17 CDC. Guidelines for preventing opportunistic infections among HIV-infected persons MMWR 2002; 51 (No. RR-08). CDC. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, MMWR 2005; 54 (No. RR-17). Errata (September 25, 2006) CDC. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. MMWR 2009; 58 (No. RR-4). CDC. Guidelines for the investigation of contacts of persons with infectious tuberculosis. MMWR 2005; 54 (No. RR-15). CDC. Guidelines for the prevention and treatment of opportunistic infections among HIV-exposed and HIV-infected children. MMWR 2009; 58 (No. RR-11). CDC. Notice to Readers: Updated guidelines on managing drug interactions in the treatment of HIV-related tuberculosis. MMWR 2008; 57 (04): CDC. Plan to combat extensively drug-resistant tuberculosis. MMWR 2009; 58 (RR-03). CDC. Prevention and control of tuberculosis in correctional and detention facilities. MMWR 2006; 55 (No. RR-09). CDC. Reported HIV status of tuberculosis patients United States, MMWR 2007; 56 (42): CDC. Reported Tuberculosis in the United States, Atlanta, Ga: U.S. Department of Health and Human Services, CDC; September CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000; 49 (No. RR-6). Updates: Adverse event data and revised American Thoracic Society/CDC recommendations against the use of rifampin and pyrazinamide for treatment of latent tuberculosis infection United States, MMWR 2003; 52 (31): Chapter 1: Overview of Tuberculosis Epidemiology in the United States 17
18 Fatal and severe liver injuries associated with rifampin and pyrazinamide for latent tuberculosis infection, and revisions in American Thoracic Society/CDC recommendations United States, MMWR 2001; 50 (34): Fatal and severe hepatitis associated with rifampin and pyrazinamide for the treatment of latent tuberculosis infection New York and Georgia, MMWR 2001; 50 (15): CDC. Treatment of tuberculosis. MMWR 2003; 52 (No. RR-11). Errata (January 7, 2005) CDC. Trends in tuberculosis morbidity United States, MMWR 2003; 52 (11): CDC. Trends in tuberculosis United States, MMWR 2008; 57 (11): CDC. Tuberculosis elimination revisited: Obstacles, opportunities, and a renewed commitment. MMWR 1999; 48 (No. RR-9). CDC. Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR 2009; 58 (01): Institute of Medicine, Committee on Elimination of Tuberculosis in the United States. Geiter L J, editor. Ending Neglect: The Elimination of Tuberculosis in the United States. Washington, D.C., National Academy Press; World Health Organization. A WHO/The Union Monograph on TB and Tobacco Control. Geneva, Switzerland;
GUIDELINES, STATEMENTS & STANDARDS ON TUBERCULOSIS [AS OF FEBRUARY 2005] PART I. GROUPED BY AGENCY/ORGANIZATION
GUIDELINES, STATEMENTS & STANDARDS ON TUBERCULOSIS [AS OF FEBRUARY 2005] PART I. GROUPED BY AGENCY/ORGANIZATION Agency/Organization Name of the Guide/Statement Available at World Health Organization 1
Chapter 5 Treatment for Latent Tuberculosis Infection
Chapter 5 Treatment for Latent Tuberculosis Infection Table of Contents Chapter Objectives.... 109 Introduction.... 111 Candidates for the Treatment of LTBI... 112 LTBI Treatment Regimens.... 118 LTBI
The Epidemiology of Tuberculosis in Minnesota,
The Epidemiology of Tuberculosis in Minnesota, 2011 2015 Minnesota Department of Health Tuberculosis Prevention and Control Program (651) 201-5414 Tuberculosis surveillance data for Minnesota are available
GUIDELINES, STATEMENTS & STANDARDS ON TUBERCULOSIS [AS OF NOVEMBER 2004] PART I. GROUPED BY AGENCY/ORGANIZATION
GUIDELINES, STATEMENTS & STANDARDS ON TUBERCULOSIS [AS OF NOVEMBER 2004] PART I. GROUPED BY AGENCY/ORGANIZATION Agency/Organization Name of the Guide/Statement Available at World Health Organization 1
Tuberculosis: The Big Picture And Challenge of Drug-resistance
5 th APHL National Conference on Laboratory Aspects of Tuberculosis August 11-13, 2008 San Diego, California Tuberculosis: The Big Picture And Challenge of Drug-resistance RADM Kenneth G. Castro, M.D.
HIV and AIDS in the United States
HIV and AIDS in the United States A Picture of Today s Epidemic More than 20 years into the AIDS epidemic, HIV continues to exact a tremendous toll in the United States. Recent data indicate that African
Chapter 4 Diagnosis of Tuberculosis Disease
Chapter 4 Diagnosis of Tuberculosis Disease Table of Contents Chapter Objectives.... 75 Introduction.... 77 Medical Evaluation.......................................................... 78 Chapter Summary...
Tuberculosis in Alameda County, 2009
Tuberculosis in Alameda County, 29 Alameda County Public Health Department Tuberculosis Overview Tuberculosis (TB) is a communicable disease caused by the bacteria Mycobacterium tuberculosis. TB is spread
TB Nurse Case Management San Antonio, Texas July 18 20, 2012
TB Nurse Case Management San Antonio, Texas July 18 20, 2012 TB Epidemiology Robert Petrossian July 18, 2012 Robert Petrossian has the following disclosures to make: No conflict of interests No relevant
Core Curriculum on Tuberculosis: What the Clinician Should Know
Core Curriculum on Tuberculosis: What the Clinician Should Know Sixth Edition 2013 National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination 1 Chapters
U.S. Preventive Services Task Force Recommendation Statement: Screening for Latent Tuberculosis Infection (LTBI) in Adults
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention U.S. Preventive Services Task Force Recommendation Statement: Screening for Latent Tuberculosis Infection (LTBI) in Adults Centers
TUBERCULOSIS. Presented By: Public Health Madison & Dane County
TUBERCULOSIS Presented By: Public Health Madison & Dane County What is Tuberculosis? Tuberculosis, or TB, is a disease caused by a bacteria called Mycobacterium tuberculosis. The bacteria can attack any
TB Transmission, Pathogenesis & Infection Control
TB Transmission, Pathogenesis & Infection Control Bradley Allen, MD, PhD, FACP, FIDSA. 2014 MFMER slide-1 Disclosures Medical Consultant, TB Control Program Indiana State Department of Health Past clinical
Tuberculosis in Alameda County, 2014 Alameda County Public Health Department
Tuberculosis in Alameda, 214 Alameda Public Health Department Tuberculosis (TB) is a preventable and curable disease that remains one of the leading causes of death worldwide. TB is a communicable disease
Tuberculosis in Alameda County, 2012
Tuberculosis in Alameda County, 212 Alameda County Public Health Department Tuberculosis Overview Tuberculosis (TB) is a preventable and curable disease that remains one of the leading causes of death
Mycobacterial Infections: What the Primary Provider Should Know about Tuberculosis
Mycobacterial Infections: What the Primary Provider Should Know about Tuberculosis Henry F. Chambers, M.D Professor of Medicine, UCSF Topics for Discussion Epidemiology Diagnosis of active TB Screening
Communicable Diseases
Communicable Diseases Communicable diseases are ones that can be transmitted or spread from one person or species to another. 1 A multitude of different communicable diseases are currently reportable in
Please evaluate this material by clicking here:
EPI Case Study 3: Cross-Sectional, Case-Control, and Cohort Studies Identification of TB Risk Time to Complete Exercise: 60 minutes LEARNING OBJECTIVES At the completion of this module, participants should
Karen E. Kim, MD Professor of Medicine Dean for Faculty Affairs Director, Center for Asian Health Equity University of Chicago
Karen E. Kim, MD Professor of Medicine Dean for Faculty Affairs Director, Center for Asian Health Equity University of Chicago 1 2 billion people have been exposed to HBV 350-400 million people chronically
Outline. AIDS & HIV in the Travis County. Global estimates for adults & children end HIV incidence worldwide
Outline AIDS & HIV in the Joshua Vest Epidemiologist Austin/ Health & Human Services Department Worldwide HIV/AIDS surveillance National Prevalence Trends Disparities Mortality Modes of exposure Risk factors
Descriptive Epidemiology Project: Tuberculosis in the. United States. MPH 510: Applied Epidemiology. Summer A 2014
Descriptive Epidemiology Project: Tuberculosis in the United States MPH 510: Applied Epidemiology Summer A 2014 June 1, 2014 1 The white plague affected thousands upon thousands of people in the 18 th
AIDS Cases by Exposure Category. Top 10 AIDS Cases by State/Territory. State HIV/AIDS Data. International Statistics
Page 1 of 7 Main Topics Basic Science Surveillance Prevention Research Vaccine Research Treatment Funding Testing Evaluation Software Capacity Building General Information» Basic Statistics Brochures Conferences
The epidemiology of tuberculosis
The epidemiology of tuberculosis Tuberculosis Workshop Shanghai, 12-22 May 28 Philippe Glaziou World Health Organization Outline Epidemiology refresher Estimates of tuberculosis disease burden Notifications
Epidemiology Update Hepatitis A
December 2011 Epidemiology Update Hepatitis A Hepatitis A Key Points Between 2000 and 2010, 209 cases of hepatitis A were reported in Hennepin County residents. This represents 30% of the cases reported
2010 global TB trends, goals How DOTS happens at country level - an exercise New strategies to address impediments Local challenges
Outline of what it will take Tuberculosis Elimination 25: Global and Local Challenges Anne Fanning, MD November 9, 211 21 global TB trends, goals How DOTS happens at country level - an exercise New strategies
Etiological Agent: Pulmonary Tuberculosis. Debra Mercer BSN, RN, RRT. Definition
Pulmonary Tuberculosis Debra Mercer BSN, RN, RRT Definition Tuberculosis is a contagious bacterial infection of the lungs caused by Mycobacterium Tuberculosis (TB) Etiological Agent: Mycobacterium Tuberculosis
TB in Prisons and Jails Albuquerque, New Mexico November 28, 2012
TB in Prisons and Jails Albuquerque, New Mexico November 28, 2012 Challenges of TB Treatment in Special Populations in Corrections Marcos Burgos, MD November 28, 2012 Marcos Burgos, MD has the following
These recommendations will remain in effect until the national shortage of PPD solution has abated.
Maryland Recommendations Regarding the National Shortage of Purified Protein Derivative (PPD) Solution; Attachment to Health Officer Memorandum National Shortages of Tubersol and Aplisol for TB Skin Testing;
TB BASICS: PRIORITIES AND CLASSIFICATIONS
TB CASE MANAGEMENT AND CONTACT INVESTIGATION INTENSIVE NOVEMBER 1-4, 2016 TB BASICS: PRIORITIES AND CLASSIFICATIONS LEARNING OBJECTIVES Upon completion of this session, participants will be able to: 1.
HIV/AIDS Perinatal Surveillance Minnesota Department of Health HIV/AIDS Surveillance System
HIV/AIDS Perinatal Surveillance 2012 Minnesota Department of Health HIV/AIDS Surveillance System Background This slide set describes births to HIV-infected women in Minnesota by person, place, and time.
Therapy for Latent Tuberculosis Infection
Screening and Treatment of LTBI in TB Control in the US Margarita Elsa Villarino MD MPH Division of TB Elimination, CDC April 14, 2004 TB Prevention and Control in the United States The fundamental strategies
birthplace and length of time in the US:
Cervical cancer screening among foreign-born versus US-born women by birthplace and length of time in the US: 2005-2015 Meheret Endeshaw, MPH CDC/ASPPH Fellow Division Cancer Prevention and Control Office
TB Epidemiology. Richard E. Chaisson, MD Johns Hopkins University Center for Tuberculosis Research
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
Continua Health Alliance Industry Statistics
Continua Health Alliance Industry Statistics Health and Wellness statistics and insights Global statistics: Worldwide obesity has more than doubled since 1980 (WHO Fact Sheet, 2008) In 2008, 1.5 billion
Estimates of New HIV Infections in the United States
Estimates of New HIV Infections in the United States CDC HIV/AIDS FactS A u g u s t 28 Accurately tracking the HIV epidemic is essential to the nation s HIV prevention efforts. Yet monitoring trends in
Salt Lake County Annual Influenza Report Season Bureau of Epidemiology
Number of Cases Salt Lake County Annual Influenza Report 6-7 Season Bureau of Epidemiology Introduction Table of Contents Introduction The 6-7 influenza season saw 6 confirmed influenza-associated hospitalizations
What can be done against XDR-TB?
What can be done against XDR-TB? Dr Matteo Zignol Stop TB Dep. World Health Organization Geneva 16 th Swiss Symposium on tuberculosis Münchenwiler, 22 March 2007 XDR-TB Extensive Drug Resistance XDR =
THE FEW REMAINING (IMPOSSIBLE) CASES
THE FEW REMAINING (IMPOSSIBLE) CASES AG Holley 60 th Anniversary Celebration AG Holley State Hospital Lantana, FL July 21, 2010 Lee B. Reichman, MD, MPH AG Holley 60th Anniversary Celebration 1 TB Historical
Tuberculosis Reporting, Waco-McLennan County Public Health District TB Control WMCPHD (254)
Tuberculosis Reporting, Waco-McLennan County Public Health District TB Control WMCPHD (254)-750-5496 Local health care providers, including physicians offices, labs and hospitals, are required by law to
Tuberculosis and the Asian Population of Tarrant County, TX. By: Jessica McCallister
Tuberculosis and the Asian Population of Tarrant County, TX By: Jessica McCallister Definition of Foreign-Born by CDC A U.S.-born person was defined as someone born in the United States or its associated
The Role of Rifampin for the Treatment of Latent TB Infection. Introduction. Introduction
The Role of Rifampin for the Treatment of Latent TB Infection March 26, 2008 Alfred A. Lardizabal, MD Associate Professor of Medicine New Jersey Medical School Global Tuberculosis institute Treatment of
Tuberculosis Disparity Between US-born African-Americans and Caucasians in Houston:
Tuberculosis Disparity Between US-born African-Americans and Caucasians in Houston: A population-based study Jose A. Serpa 1, M.D.; Larry D. Teeter 2, Ph.D., James M. Musser 2, M.D., Ph.D. and Edward A.
Cervical Cancer Screening and Prevention in Latinas. Sandra Torrente, MD, MSc Kenneth Grullon, MD
ç Cervical Cancer Screening and Prevention in Latinas Sandra Torrente, MD, MSc Kenneth Grullon, MD Objectives Cervical cancer epidemiology Cervical cancer screening rates locally Health Disparities of
Racial and Ethnic Health Disparities Report Card
Racial and Ethnic Health Disparities Report Card August 2010 Acknowledgements Many individuals contributed to the production of this report card. The Division of Policy and Performance wishes to particularly
Diagnosis Latent Tuberculosis. Disclosures. Case
Diagnosis Latent Tuberculosis Neha Shah MD MPH Field Medical Officer Tuberculosis Control Branch California Department of Public Health Centers for Disease Control and Prevention September 2016 1 Disclosures
Self-Study Modules on Tuberculosis
Self-Study Modules on Tuberculosis Transmission and Pathogenesis of Tube rc ulos is U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for HIV/AIDS,
TB Intensive San Antonio, Texas December 1-3, 2010
TB Intensive San Antonio, Texas December 1-3, 2010 TB & Diabetes Barbara Seaworth, MD; HNTC December 3, 2010 Dual Epidemic Diabetes - Tuberculosis Barbara J. Seaworth MD Medical Director, Heartland NTBC
Background. Background Epidemiology. Stop TB in the African-American Community. Stop TB in the African-American Community
Community 11 th Annual Conference of the International Union Against Tuberculosis and Lung Disease North America Region February 23 rd, 27 Nickolas DeLuca, PhD Communications, Education, and Behavioral
Mortality Slide Series. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention
Mortality Slide Series National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention HIV Mortality Slides An analysis of trends in rates and distributions of deaths
Center for Health Disparities Research
Center for Health Disparities Research EXHIBIT I Legislative Committee on Health Care Document consists of 23 pages. Entire document provided. Due to size limitations, pages provided. A copy of the complete
Population. B.4. Malaria and tuberculosis
Statistical Yearbook for Asia and the Pacific 2013 B. Health B.4. Malaria and tuberculosis Malaria and tuberculosis (TB) are two infectious and potentially lethal diseases that have greatly affected the
MULTIDRUG- RESISTANT TUBERCULOSIS. Dean Tsukayama Hennepin County Medical Center Hennepin County Public Health Clinic
MULTIDRUG- RESISTANT TUBERCULOSIS Dean Tsukayama Hennepin County Medical Center Hennepin County Public Health Clinic I have no relevant financial relationships. Discussion includes off label use of: amikacin
CHAPTER 29 HIV/AIDS BOARD OF HEALTH ROLE AT A GLANCE
CHAPTER 29 HIV/AIDS BOARD OF HEALTH ROLE AT A GLANCE Have an understanding of who can be affected by HIV/AIDS in your community and be able to address any concerns of the general public as well as people
5. Over the last ten years, the proportion of HIV-infected persons who are women has: a. Increased b. Decreased c. Remained about the same 1
Epidemiology 227 April 24, 2009 MID-TERM EXAMINATION Select the best answer for the multiple choice questions. There are 60 questions and 9 pages on the examination. Each question will count one point.
TOBACCO USE AND ETHNICITY
TOBACCO USE AND ETHNICITY Adult and youth tobacco use rates and related smoking-caused death rates vary considerably among different ethnic groups in the United States. Adult Prevalence 15.5 percent of
Controlling TB in the era of HIV
Controlling TB in the era of HIV Christy Hanson, PhD, MPH TB Research Advisor Amy Bloom, MD TB/HIV Advisor TB Incidence rates highest in Africa Estimated new TB cases (all forms) per 100 000 population
HIV and Tuberculosis in Eastern Europe
HIV and Tuberculosis in Eastern Europe Daria N. Podlekareva Meeting Standard of Care for HIV and Coinfections in Europe Rome, November 25-16 2014 TB notification rates (per 100.000) European region 2012
When Can Isolation Be Discontinued?
When Can Isolation Be Discontinued? - It Depends on the Patient and the Setting. Masae Kawamura M.D. and Barbara Seaworth M.D. Texas: (800) TEX-LUNG New Jersey: 973-972-3270? HNTC Consultation Line California:
Washington, DC Washington, DC Washington, DC Washington, DC 20515
September 6, 2016 The Honorable Mitch McConnell The Honorable Harry Reid Majority Leader Minority Leader U.S. Senate U.S. Senate Washington, DC 20510 Washington, DC 20510 The Honorable Paul Ryan The Honorable
The Tip of the Iceberg: Addressing Latent Tuberculosis Infection to Accelerate Tuberculosis Elimination
Four Corners TB and HIV Conference November 3, 2015 Durango, CO The Tip of the Iceberg: Addressing Latent Tuberculosis Infection to Accelerate Tuberculosis Elimination Philip LoBue, MD National Center
Rhode Island Department of Health. Division of Infectious Disease and Epidemiology. Office of HIV/AIDS & Viral Hepatitis
Rhode Island Department of Health Division of Infectious Disease and Epidemiology Office of HIV/AIDS & Viral Hepatitis November 2013 Table of Contents 1) Introduction.....3 2) Surveillance Methods...3
GLOBAL STATISTICS FACT SHEET 2015
FACT SHEET 2015 GLOBAL STATISTICS 15.8 people accessing antiretroviral therapy (June 2015) 36.9 [34.3 41.4 ] people globally were living with HIV (end 2014) 2 [1.9 2.2 ] people became newly infected with
HEALTH OF WOMEN AND CHILDREN REPORT
HEALTH OF WOMEN AND CHILDREN REPORT MARCH 2018 The full report is available at www.americashealthrankings.org OVERVIEW Promoting the health of women, infants and children is fundamental to keeping our
GLOBAL HIV STATISTICS
F A C T S H E E T W O R L D A I D S D A Y 2017 GLOBAL HIV STATISTICS 20.9 million people were accessing antiretroviral therapy in June 2017. 36.7 million [30.8 million 42.9 million] people globally were
Stop TB Working Group on DOTS-Plus for MDR-TB Strategic Plan
Stop TB Working Group on DOTS-Plus for MDR-TB Strategic Plan 2006-2015 Background Current threat and status of the global epidemic of multidrug resistant tuberculosis (MDR-TB) Along with HIV/AIDS, MDR-TB
Trends in HIV Incidence and Prevalence in the United States
Trends in HIV Incidence and Prevalence in the United States Irene Hall, PhD, FACE 7th International Workshop on HIV Transmission Washington, DC, July 20, 2012 National Center for HIV/AIDS, Viral Hepatitis,
10/3/2017. Updates in Tuberculosis. Global Tuberculosis, WHO 2015 report. Objectives. Disclosures. I have nothing to disclose
Disclosures Updates in Tuberculosis I have nothing to disclose Chris Keh, MD Assistant Clinical Professor, Division of Infectious Diseases, UCSF TB Controller, TB Prevention and Control Program, Population
Targeted Outreach & Other Strategies for Increasing HCV Testing
Targeted Outreach & Other Strategies for Increasing HCV Testing Working in Settings that Serve High-Risk Populations Webcast 2.4 Presented By: Denise Stinson, MN, RN Tacoma-Pierce County Health Department
aids in asia and the pacific
HIV AIDS AND DEVELOPMENT IN ASIA AND THE PACIFIC a lengthening shadow aids in asia and the pacific World Health Organization Regional Offices for South East Asia and the Western Pacific Region 9 10 OCTOBER
Recognizing MDR-TB in Children. Ma. Cecilia G. Ama, MD 23 rd PIDSP Annual Convention February 2016
Recognizing MDR-TB in Children Ma. Cecilia G. Ama, MD 23 rd PIDSP Annual Convention 17-18 February 2016 Objectives Review the definitions and categorization of drugresistant tuberculosis Understand the
Hepatitis B: A Preventable Cause of Liver Cancer. Saira Khaderi MD, MPH Assistant Professor of Surgery Associate Director, Project ECHO June 17, 2016
Hepatitis B: A Preventable Cause of Liver Cancer Saira Khaderi MD, MPH Assistant Professor of Surgery Associate Director, Project ECHO June 17, 2016 Overview Epidemiology HBV and cancer Screening, Diagnosis
DRUG RESISTANCE IN TUBERCULOSIS CONTROL. A GLOBAL AND INDIAN SITUATION
JOURNAL OF PREVENTIVE MEDICINE 2008; 16(3-4): 3-9 Inviting Editorial DRUG RESISTANCE IN TUBERCULOSIS CONTROL. A GLOBAL AND INDIAN SITUATION Harshad Thakur Centre for Health Policy, Planning and Management,
Mortality Slide Series. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention
Mortality Slide Series National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention HIV Mortality Slides An analysis of trends in rates and distributions of deaths
Asking the Right Questions. A Visual Guide to Tuberculosis Case Management for Nurses. Reference Guide
Asking the Right Questions A Visual Guide to Tuberculosis Case Management for Nurses Reference Guide The Francis J. Curry National Tuberculosis Center is a joint project of the San Francisco Department
If you suspect Fido's owner is diverting prescription pain meds meant for the pet, checking your state's drug monitoring database may not help
Prescriptions If you suspect Fido's owner is diverting prescription pain meds meant for the pet, checking your state's drug monitoring database may not help by Ann M. Philbrick, PharmD, BCPS The Centers
TB and Respiratory Protection
Slide 1 TB and Respiratory Protection Tuberculosis (TB) is a disease present throughout the United States. Lehigh Valley Health Network is concerned about your health and needs your help to prevent the
Progress on the targets of Millennium Development Goal 6 in central and eastern Europe and central Asia
Progress on the targets of Millennium Development Goal 6 in central and eastern Europe and central Asia 11 October 2011 Moscow, Russian Federation Zsuzsanna Jakab WHO Regional Director for Europe Millennium
Health Status Disparities in New Mexico Identifying and Prioritizing Disparities
Health Status Disparities in New Mexico Identifying and Prioritizing Disparities Public Health Division March 23 Health Status Disparities in New Mexico Identifying and Prioritizing Disparities New Mexico
Revised National Tuberculosis Control Programme (RNTCP) Dr.Kishore Yadav J Assistant Professor
Revised National Tuberculosis Control Programme (RNTCP) Dr.Kishore Yadav J Assistant Professor Global scenario*: Burden of TB Incidence : 9.6 million (58% SEAR and Western Pacific) Deaths : 1.5 million
Sirturo: a new treatment against multidrug resistant tuberculosis
Sirturo: a new treatment against multidrug resistant tuberculosis TB is an on-going problem WHO estimated incidence of new TB cases 2009 Global Tuberculosis Control: WHO report 2010. Available at: http://www.who.int/tb/publications/global_report/2010/en/index.html
511,000 (57% new cases) ~50,000 ~30,000
Latest global TB estimates - 2007 (Updated Mar 2009) All forms of TB Greatest number of cases in Asia; greatest rates per capita in Africa Multidrug-resistant TB (MDR-TB) Estimated number of cases 9.27
A Briefing Paper on Rotavirus
COMMON VIRUS AND SENSELESS KILLER: A Briefing Paper on Rotavirus DIARRHEA KILLS. MOTHERS IN THE WORLD S POOREST COUNTRIES KNOW THIS ALL TOO WELL. It s a fact few people in wealthier nations realize. Rotavirus
Questions and Answers About
Questions and Answers About TB 2002 DEPARTMENT OF HEALTH AND HUMAN SERVICES n Questions and Answers About TB 2002 DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National
HIV/AIDS Surveillance Technical Notes
HIV/AIDS Surveillance Technical Notes Surveillance of HIV/AIDS The Minnesota Department of Health (MDH) collects case reports of HIV infection and AIDS diagnoses through a passive and active HIV/AIDS surveillance
From Exposure to Disease: The Role of Environmental Factors in Susceptibility to and Development of Tuberculosis
Epidemiologic Reviews Copyright 2001 by the Johns Hopkins University Bloomberg School of Public Health All rights reserved Vol. 23, No. 2 Printed in U.S.A. From Exposure to Disease: The Role of Environmental
Investigation of Contacts of Persons with Infectious Tuberculosis, 2005
1 Investigation of Contacts of Persons with Infectious Tuberculosis, 2005 Daniel P. Dohony, MPH Division of Tuberculosis Elimination Centers for Disease Control and Prevention and Philadelphia TB Control
Replaces: 02/11/16. Formulated: 7/95 EMPLOYEE TB TESTING
Effective : 02/09/17 Page 1 of 4 PURPOSE: To describe the process where by employees may obtain routine TB skin testing by facility medical staff. POLICY: Employees of the Texas Department of Criminal
Impact of Poor Healthcare Services
Competency 3 Impact of Poor Healthcare Services Updated June 2014 Presented by: Lewis Foxhall, MD VP for Health Policy Professor, Clinical Cancer Prevention UT MD Anderson Cancer Center Competency 3 Objectives
TOBACCO USE AMONG AFRICAN AMERICANS
TOBACCO USE AMONG AFRICAN AMERICANS Each year, approximately 45,000 African Americans die from smoking-related disease. 1 Smoking-related illnesses are the number one cause of death in the African-American
UNAIDS 2013 AIDS by the numbers
UNAIDS 2013 AIDS by the numbers 33 % decrease in new HIV infections since 2001 29 % decrease in AIDS-related deaths (adults and children) since 2005 52 % decrease in new HIV infections in children since
Latent Tuberculosis Best Practices
Latent Tuberculosis Best Practices Last Updated September 7, 2016 LTBI Demographics in the US o 13million people in the US with LTBI (estimate) o In 2014, approximately 66% of TB cases in the United States
LATENT TUBERCULOSIS. Robert F. Tyree, MD
LATENT TUBERCULOSIS Robert F. Tyree, MD 1 YK TB OFFICERS Ron Bowerman Elizabeth Roll Mien Chyi (Pediatrics) Cindi Mondesir (Pediatrics) The new guys: Philip Johnson Robert Tyree 2009 CDC TB CASE DEFINITION
Tuberculosis in Pregnancy
Tuberculosis in Pregnancy 1. Screening for Latent Tuberculosis Infection (LTBI) WHO to screen? Those at high risk for contracting TB and converting from latent to active TB Known HIV infection Close contact