Epidemiology of TB: A Local and National Overview
|
|
- Francis McBride
- 5 years ago
- Views:
Transcription
1 Epidemiology of TB: A Local and National Overview Sonal S. Munsiff, MD Director, Bureau of Tuberculosis Control NYC Department of Health and Mental Hygiene Medical Officer, DTBE, CDC February 4, 24 Tuberculosis in New York City: The Last Decade Tuberculosis Cases and Rates New York City, Tuberculosis rates by borough New York City, 1991 Number of cases Case Rate # Cases Rate/1, Cases per 1,/year Manhattan.8 Bronx 47.1 Brooklyn 27 Queens 9.8 Richmond NYC DOH Rates of natural resistance in M. tuberculosis soniazid 1 in 1 6 Rifampin 1 in 1 8 Ethambutol 1 in 1 6 Streptomycin 1 in 1 NH & RF 1 in 1 14 Number of organisms in a TB cavity =
2 Pathogenesis of Drug Resistance Pathogenesis of Drug Resistance R NH RF PZA R R i R NH RF NH R R R R R R R R R R R R R R How to get MDRTB Acquired resistance Non adherence to therapy inappropriate therapy Primary resistance nosocomial transmission community transmission Emergence of Resistance (nappropriate Therapy) Treatment 6/9 9/9 2/91 soniazid Rifampin Ethambutol Smear Culture Susceptibility soniazid R R R Rifampin S R R Ethambutol S S R Emergence of Resistance (Nonadherence and nappropriate Therapy) Treatment 6/9 9/9 12/9 3/91 6/91 soniazid Rifampin Ethambutol? DOT Smear Culture Susceptibility soniazid S R R R Rifampin S S S R Ethambutol S S R R Evolution of Drug Resistance in a Community First (mis) treatment 3-8 years Acquired resistance New nfection 7-12 years 1-1 years Disease with primary resistance years 2
3 Causes of resurgent tuberculosis in New York City Poverty, homelessness, crowding, substance abuse TB abroad on the rise; immigration from high prevalence countries HV/ADS epidemic Decline of public health infrastructure; lack of accessible health care Marked reduction in TB control program staff and clinic facilities By 1989, less than half of patients who began treatment were cured Percent resistant Patients with resistant isolates New York City, 1991(N=466) Any Anti-TB agent 12. NH NH/RF Never treated Previously treated Nosocomial, HV- related outbreaks of multidrug- resistant TB as of October, 1992 Facility Location Time Period Total Hospital A Miami Hospital B NYC Hospital C NYC Hospital D NYC Hospital E NYS Hospital F NYC Hospital NJ Hospital J NYC Prisons* NYS Total Cases 297 * 24 prison cases are also counted with Hospital C Prevalence of HV and mortality of patients with multidrug-resistant TB as of Oct., 1992 Facility HV+ Mortality Median nterval Hospital A 93% 72% 7 weeks Hospital B* 1% 89% 16 weeks Hospital C 9% 77% 4 weeks Hospital D 91% 83% 4 weeks Hospital E 14% 43% 4 weeks Hospital F 82% 82% 4 weeks Hospital 1% 8% 4 weeks Hospital J 96% 93% 4 weeks Prison System ** 98% 79% 4 weeks * HV infection was part of case definition ** ncludes 24 cases also counted with Hospital C Nosocomial Tuberculosis Common Characteristics Diagnosis was not considered or late diagnosis CXR often atypical for TB neffective or inadequate isolation Most cases in HV seropositive patients Multidrug-resistant strains standard treatment not effective Appropriate treatment also often ineffective for prolonged periods Laboratory results delayed A Multi-institutional Outbreak of Highly Drug-Resistant Tuberculosis Frieden et al. JAMA 1996;276:
4 Characteristics of strain W outbreak Patient Selection Patients were selected from those cared for at public and nonpublic institutions from January 1, 199 to August 1, 1993 Patients had to have isolates resistant to at least /R/E/S and RBT, if testing included it For those suspected of having strain W TB, results of isolate testing by RFLP had to have an identical or closely related pattern to strain W Characteristics of strain W outbreak Results 37 patients met case definition, 267 had isolates for RFLP 78% were sputum AFB smear positive Of 249 with known serostatus, 23 (92%) were HV+ Median survival for the 23 HV+ patients was 66 days 221 HV+ patients had positive cultures from a pulmonary source Patients with strain W had more documented HV infection than other CX+ TB patients (86% vs. 37% ; P<.1) Characteristics of strain W outbreak Epidemiological links (7%) had isolates available for RFLP testing 237 isolates had an identical RFLP pattern (strain W) 3 isolates had RFLP patterns that were very similar to strain W Patients resided in all boroughs and most zip codes in NYC Cared for at 41 hospitals and hospitalized for 19,74 days Characteristics of strain W outbreak Epidemiological links (7%) of 267 were epidemiologically linked 178 (96%) occurred in 11 different hospitals (range 1-76 case/hospital) 3 (2%) were linked in the correctional system (3%) were linked in the community Outbreaks lasted up to 38 months and most took place in 4 hospitals Median time from exposure to disease was 17 weeks Nursery exposure A MDRTB Transmission in a Hospital Nursery H B C H H TB Control: The components of DOTS Political commitment Diagnosis by microscopy Adequate supply of the right drugs Directly observed treatment Accountability TB Register 1991 Dec June 1993 Dec June 1994 Nivin et al. CD. 1998;26:33-7 4
5 Programmatic measures used to control TB in NYC DOT as standard of care ntensive case management Detention until cure for least adherent mproved nfection Control Hospitals Correctional facilities Changes in empiric treatment regimens Mandatory susceptibility testing and reporting 3, 3, 2, 2, 1, 1, Tuberculosis Cases and Rates New York City, * Rate/1, 4, Case Rate 4, # Cases * Rates since are based on Census data. Trends in Tuberculosis - 1 New York City, % fewer cases since % fewer MDRTB cases 88.4% fewer US-born cases 76.9% fewer cases in 2-44 year age group Trends in Tuberculosis - 2 New York City, HV-infected cases decreased from 34% in 1992 to 1% in 21, increasing to 18% in 22 Females increased from 28% in 1986 to 39% in 22 Non-US-born cases increased from 18% in 1992 to 66% in 21, decreasing to 6% in 22 Tuberculosis Cases New York City, Cases Patients on DOT Federal Budget $ in Millions
6 Cluster size among NYC TB patients during three surveys Clustering among NYC TB patients during three surveys Number of clusters Number of patients per cluster Percentage Clustered US born Non US born % 32% 18 18% Percent Clustered Risk factors associated with clustering of TB in NYC MDRTB Black Race Homeless US Born HV Positive DNA Clustering by country of origin, NYC US-Born Patients Non US-Born Patients Clustered Total Culture Clustered Cases Total Culture Overall Cases No. Positive No. (%) Positive % Clustering (%) Cross-Sectional Surveys (NYC April Studies) 1991* % % 37% 1994** % % 32% 1997** % % 18% NYC ncident ME Project cases (2 years) RFLP alone for cases >3 bands % % 29% RFLP and Spoligo for ALL Cases % % 33% * Frieden, et al, 199: includes only cases with strains of >3 RFLP bands. **Unpublished study includes only cases with strains of >3 RFLP bands. Number and Size of DNA Clusters (N=132 clusters) Multivariate Analysis Clustering Number of Clusters Variable Age <6 US-Born Asian History of TB or LTB Low band RFLP OR Adjusted (9% C) Cluster Size (Patients per Cluster) 6
7 Reported TB Cases United States, TB Case Rates, United States, 22 No. of Cases Rate: cases per 1, D.C. < 3. (year target) >.2 (national average) Cases per 1, 2 TB Case Rates by Age Group United States, TB Case Rates by Age Group and Sex, United States, < Age Group (years) Cases per 1, <1 yrs 1-24 yrs 2-44 yrs 4-64 yrs 6+ yrs Male Female Cases per 1, TB Case Rates by Race/Ethnicity United States, Crude Case Rates by Borough New York City, Crude rate/1, New York City Staten sland Queens Bronx Brooklyn Manhattan Asian/Pacific slander Black, non-hispanic Hispanic American ndian/alaska Native White, non-hispanic
8 Health Districts with Case Rate* $2 New York City, 22 Case rates per 1, Central Harlem Manhattan Queens Brooklyn Corona L East Side Bushwick Astoria-LC Fort Greene * Rates per 1, based on Census data. Percent of Eligible* Tuberculosis Patients on Directly Observed Therapy** New York City, 21 % on DOT MDR 7.1 Pulm. smearpositive 82.6 Any DOHMH Rx * Eligible patients were those diagnosed while alive and who received some treatment on an outpatient basis. ** Ever on DOT as of March of the year after being confirmed as a case of tuberculosis All 4 2 Trend in HV-nfection and TB New York City, % of Cases TB/HV nfected 1,4 % TB/HV+ 34% 1,2 33% 34% 33% # TB/HV+ 31% 4 1, 26% 8 22% 22% 3 18% 18% 6 1% HV nfection and Tuberculosis New York City, 22 % of Cases 2.4% 13.7% Males (N = 667) Females (N = 417) 47.2% 48.2% 38.1% 32.4% HV+ HV- Unknown % Coinfection Estimated HV Coinfection in Persons Reported with TB United States, All Ages Aged 2-44 Note: Minimum estimates based on reported HV-positive status among all TB cases in the age group. All 21 cases from California have an unknown HV status. 8
9 HV-nfected US-Born TB Cases New York City, ,4 1,2 1, % nfected # TB/HV Multidrug-Resistant TB* New York City, * *1991 data are incomplete **multidrug-resistant TB or MDRTB: resistant to at last NH & RF W and related strain epidemic curve in NYC, MDRTB Strain W and Variants Number of strains Major multidrug-resistant strains in New York City, W W1 H AB P AU C P1 Other Unique Drug Resistance in New York City, Primary Anti-TB Drug Resistance United States, % of all Cx+ cases with susceptibility results who had drug resistance MDR-TB: resistant to at least NH & RF ODR-TB: resistance to other first-line drugs MDRTB Non MDRTB % Resistant soniazid MDR TB Note: Based on initial isolates from persons with no prior history of TB. MDR TB defined as resistance to at least isoniazid and rifampin. 9
10 US* and Non-US Born TB Cases New York City, , 3, US-Born Non-US-Born 3,132 2, 2, 1, 1, 7 1, Puerto Rico and U.S. Virgin slands are included as U.S.-born There were 22 cases with unknown country of birth Non-US Born Tuberculosis Cases New York City, % of NYC Cases Percent (66%) 12 1 # of Cases *NYC cases with known country of birth Tuberculosis Cases by Area of Birth and Borough, New York City, Unknown Non-US Born U.S.-born Manhattan Queens Brooklyn Bronx Staten sland 14.9* 14.3* 14.* 12.*.6* *Rate per 1, based on Census High-Burden TB Countries* 1. ndia 12. Kenya 2. China 13. Vietnam 3. ndonesia 14. Tanzania 4. Nigeria 1. Brazil. Bangladesh 16. Thailand 6. Ethiopia 17. Uganda 7. Philippines 18. Myanmar 8. Pakistan 19. Mozambique 9. South Africa 2. Cambodia 1. Russian Federation 21. Zimbabwe 11. DR Congo 22. Afghanistan *As per the World Health Organization Top 1 Countries of Birth NYC TB Cases 22 China Ecuador Dominican Republic ndia Haiti Mexico Republic of Korea Bangladesh Pakistan Russia No. of Cases Number of TB Cases in U.S.-born vs. Foreign-born Persons United States, U.S.-born Foreign-born 1
11 Percentage of TB Cases Among Foreign-born Persons, US >% 2%-49% <2% Cases per 1, TB Case Rates in U.S.-born vs. Foreign-born Persons, United States, U.S. Overall U.S.-born Foreign-born Countries of Birth for Foreign-born Persons Reported with TB United States, 22 Length of U.S. Residence Prior to TB Diagnosis, United States, 22 Other Countries (38%) S. Korea (3%) Haiti (3%) China (%) Mexico (2%) Philippines (11%) Vietnam ndia (8%) (7%) 1% 8% 6% 4% 2% % All Philippines Mexico Vietnam <1 yr 1-4 yrs > yrs New York City Population, 199 and NYC non-us Born Population by Borough % Native non-us Born Non-English speaking 1 Bronx Brooklyn Manhattan Queens Staten sland Source: 199 and Census Profiles Population Division, NYC Department of City Planning Source: 199 and Census Profiles, Population Division, NYC Department of City Planning 11
12 Percent NYC non-us born Population Entering US in Past Ten s Bronx Brooklyn Manhattan Queens Staten sland Source: 199 and Census Profiles Population Division, NYC Department of City Planning NYC non-us born Population by Region Europe Asia Africa Oceania Latin Region America* Northern America 199 Not Reported *ncludes Mexico and Caribbean Source: 199 and Census Profiles, Population Division, NYC Department of City Planning NYC Population and TB Case Rates: Top 12 Countries of Origin for TB cases NYC population 1,222,737 n US <1 years* 384,226 Expected TB cases using: Total population 1,839 n US <1 years 617 Actual 21 Cases in NYC 6 *Estimate applying regional % in US <1 yrs to country-specific population Sources: US Census and WHO estimated TB case rates Limitations of Census Data 199 Census denominators - overestimate incidence rate Time spent outside US for US-born, and reentry for non-us born unavailable mmigration status of non-us born TB cases not available Current Prevention Strategies mproving LTB treatment completion for high risk individuals Targeted testing in high risk communities Screening of immigrants dentifying missed opportunities for TB prevention LTB Treatment Treatment for LTB is resource intensive and has limited success soniazid treatment for 9-12 months is 7% effective Cost per case prevented $14,8 Cost per TB case $16,391 But if completion rate is %, it is not cost effective Source: nstitute of Medicine, Ending Neglect, 12
13 7% 6% % 4% 3% 2% 1% % LTB Treatment Completion Rates DOHMH Chest Centers Contacts Medical Population Yield of targeted tuberculin testing is low Results of targeted testing in Haitian and Ecuadorian communities, NYC (n=38) TST positive (n=116) 38% Completed medical evaluation 9% Started treatment for LTB 33% Completed treatment 13% *21 data are preliminary Screening of mmigrants/refugees mmigrants/refugees (>1 years of age) are screened by chest x-ray and sputa before entry Non-infectious disease - required to report to health department at destination Account for small proportion of foreign-born cases n NYC, on average 2/year 2% of FB cases in 21 Excludes majority of foreign-born (tourists, students, temporary workers, undocumented) Will there always be 1 TB cases per year in NYC? Non-US born population increasing in NYC Prevention strategies are resource intensive and have limited success mmigrant screening abroad covers small proportion of cases in non-us born Case rates in country of origin and recent arrival in US strongest predictors of disease mported TB likely to continue to contribute significantly to NYC cases in near future Challenges in the Future HV infection and congregate settings Continued high immigration from high incidence countries Potential for decreased vigilance in hospitals Decreased funding nternational TB efforts not moving at the pace needed to fulfill WHO goals 13
Global, National, Regional
Epidemiology of TB: Global, National, Regional September 13, 211 Edward Zuroweste, MD Chief Medical Officer Migrant Clinicians Network Assistant Professor of Medicine Johns Hopkins School of Medicine Epidemiology
More information4/25/2012. The information on patterns of infection and disease can assist in: Assessing current and evolving trends in TB
Sindy M. Paul, MD, MPH, FACPM May 1, 2012 The information on patterns of infection and disease can assist in: Assessing current and evolving trends in TB morbidity, including resistance Identifying people
More informationGlobal, National, Regional
Epidemiology of TB: Global, National, Regional September 13, 211 Edward Zuroweste, MD Chief Medical Officer Migrant Clinicians Network Assistant Professor of Medicine Johns Hopkins School of Medicine Epidemiology
More informationANNUAL TUBERCULOSIS REPORT OREGON Oregon Health Authority Public Health Division TB Program November 2012
ANNUAL TUBERCULOSIS REPORT OREGON 211 Oregon Health Authority Public Health Division TB Program November 212 Page 2 Table of Contents Charts Chart 1 TB Incidence in the US and Oregon, 1985-211... page
More informationChapter 1 Overview of Tuberculosis Epidemiology in the United States
Chapter 1 Overview of Tuberculosis Epidemiology in the United States Table of Contents Chapter Objectives.... 1 Progress Toward TB Elimination in the United States... 3 TB Disease Trends in the United
More information- contact tracing (source)
TB Control in New York City: Current status and progress towards elimination Chrispin Kambili, MD Assistant Commissioner of Health Director, Bureau of TB Control, NYC DOHMH Every 2 Seconds someone somewhere
More informationAnnual Tuberculosis Report Oregon 2007
Annual Tuberculosis Report Oregon 7 Oregon Department of Human Services Public Health Division TB Program April 8 Page 2 Table of Contents Charts Chart 1 TB Incidence in the US and Oregon, 1985-7.. page
More informationThe American Experience with TB Elimination
Reaching the Goal of TB Elimination by 2035 March 3, 2015 The American Experience with TB Elimination John Jereb, M.D. Medical officer Division of Tuberculosis Elimination National Center for HIV/AIDS,
More informationThe 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
More information2016 Annual Tuberculosis Report For Fresno County
206 Annual Tuberculosis Report For Fresno County Cases Rate per 00,000 people 206 Tuberculosis Annual Report Fresno County Department of Public Health (FCDPH) Tuberculosis Control Program Tuberculosis
More informationTuberculosis Populations at Risk
Tuberculosis Populations at Risk One-third of the world is infected with TB, an average of one new infection per second Two million people died from tuberculosis in 2010, 1 every 20 seconds TB is the leading
More informationScott Lindquist MD MPH Tuberculosis Medical Consultant Washington State DOH and Kitsap County Health Officer
Tuberculosis in the 21 st Century Scott Lindquist MD MPH Tuberculosis Medical Consultant Washington State DOH and Kitsap County Health Officer Feedback Poll In my opinion, the recent media coverage of
More informationTuberculosis Epidemiology
Tuberculosis Epidemiology TB CLINICAL INTENSIVE COURSE Curry International Tuberculosis Center October 18, 2017 Varsha Hampole, MPH Tuberculosis Control Branch California Department Of Public Health Outline
More informationPlease 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
More informationSubstance Abuse and Tuberculosis Springfield, IL April 27, 2011
5/6/2011 Substance Abuse and Tuberculosis Springfield, IL April 27, 2011 Epidemiology of Substance Abuse and Tuberculosis: Where is the Problem? Debra Stephens, RN, BSN, MPH April 27, 2011 Debra Stephens,
More informationTuberculosis in Chicago 2007
City of Chicago Communicable Disease Information Department of Public Health Richard M. Daley, Mayor May 2008 Terry Mason, MD, FACS, Commissioner www.cityofchicago.org/health/ West Side Center For Disease
More informationThe 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
More informationTuberculosis Surveillance
Tuberculosis Surveillance Cambridge Surveillance Report on Active Tuberculosis, 26-21 Division of Epidemiology and Data Services April 211 Photo of Gram-positive Mycobacterium tuberculosis bacteria. Source:
More informationTB EPIDEMIOLOGY. Outline. Estimated Global TB Burden, TB epidemiology
TB EPIDEMIOLOGY TB Clinical Intensive Course Curry International Tuberculosis Center September 30, 2015 Varsha Nimbal, MPH Tuberculosis Control Branch California Department of Public Health 1 Outline TB
More information2008 Tuberculosis Report
2008 Tuberculosis Report County of Sacramento Department of Health and Human Services Division of Public Health Page 1 Table of Contents Figure 1. Tuberculosis Incidence Rates, County of Sacramento Vs
More informationHIV/AIDS IN FOREIGN-BORN NEW YORKERS
HIV/AIDS IN FOREIGN-BORN NEW YORKERS Ellen Weiss Wiewel, MHS HIV Epidemiology and Field Services Program New York City Department of Health and Mental Hygiene http://www.nyc.gov/html/doh/html/dires/hivepi.shtml
More informationAppendix 3 Sample size and cost of surveys
Appendix 3 Sample size and cost of surveys Here we estimate the sample sizes needed to carry out prevalence of infection and disease, incidence of disease and verbal autopsy surveys in the 22 high burden
More informationTB trends and TB genotyping
Management of a TB Contact Investigation for Public Health Workers Albuquerque, NM October 1, 214 TB trends and TB genotyping Marcos Burgos MD October 1, 214 Marcos Burgos, MD has the following disclosures
More informationI. Demographic Information GENDER NUMBER OF CASES PERCENT OF CASES. Male % Female %
San Joaquin County (SJC) in 03, (N=43) County Rate = 6. Cases per 00,000 Population I. Demographic Information Table I-A: TB cases by gender, SJC, 03 (N=43) GENDER NUMBER OF CASES Male 6 60.5% Female 7
More informationSummary Statistics of Reported and Verified Cases of Tuberculosis in San Joaquin County in 2012, (N=44) County Rate = 6.3 Cases per 100,000 Population
I. Demographic Information GENDER NUMBER OF CASES PERCENT OF CASES Male 29 65.9% Female 15 34.1% AGE GROUP NUMBER OF CASES PERCENT OF CASES 04 3 6.8% 514 2 4.5% 1524 3 6.8% 2544 6 13.6% 4564 15 34.1% 65+
More informationTuberculosis Impact in Boston Residents: 2012
Tuberculosis Impact in Boston Residents: 2012 BOSTON PUBLIC HEALTH COMMISSION Infectious Disease Bureau Communicable Disease Control Division Number of TB Cases: Boston, 1995-2012 200 180 160 140 Number
More information2014 Annual Report Tuberculosis in Fresno County. Department of Public Health
214 Annual Report Tuberculosis in Fresno County Department of Public Health www.fcdph.org Tuberculosis (TB) is a common communicable disease caused by the bacterium Mycobacterium tuberculosis and occasionally
More information2015 Annual Report Tuberculosis in Fresno County. Department of Public Health
215 Annual Report Tuberculosis in Fresno County Department of Public Health www.fcdph.org Number of Cases Rate per 1, Population 215 Tuberculosis Annual Report Fresno County Department of Public Health
More informationTB Disease Prevalence Survey - Progress Report
TB Disease Prevalence Survey - Progress Report 30 Oct 2011, Lille Ikushi Onozaki MD, MPH Team Leader, TB Prevalence Survey WHO Global Task Force on TB Impact Measurement Stop TB Department, WHO onozakii@who.int
More informationTB Disease Prevalence Survey - Overview and Introduction of the TF
TB Disease Prevalence Survey - Overview and Introduction of the TF Ikushi Onozaki MD, MPH Team Leader, TB Prevalence Survey WHO Global Task Force on TB Impact Measurement Stop TB Department, WHO onozakii@who.int
More informationTB-Free California: How close are we? How can we get closer?
TB-Free California: How close are we? How can we get closer? California TB Controllers Association April 21, 2015 Pennan Barry, MD, MPH Chief, Surveillance and Epidemiology Section Acknowledgments Local
More informationTHE 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
More informationTB 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
More informationDisclosures. TB and CoMorbidities Challenges and Opportunities. Burden of TB. Outline of the lecture. Target testing for TB Infection TB HIV 3/25/2012
Disclosures TB and CoMorbidities Challenges and Opportunities E. Jane Carter, M.D. Associate Professor of Medicine Alpert School of Medicine, Brown University Providence, Rhode Island No financial disclosures
More informationTUBERCULOSIS (TB) SCREENING AND TESTING
TUBERCULOSIS (TB) SCREENING AND TESTING COMMUNITY CARE FACILITIES LICENSING PROGRAM Tuberculosis (TB) is a contagious infectious disease caused by the bacteria Mycobacterium tuberculosis which is a slow-growing
More informationTuberculosis in Chicago 2006
Chicago Department of Public Health May 27 Communicable Disease Information Tuberculosis in Chicago 26 City of Chicago Richard M. Daley, Mayor Department of Public Health Terry Mason, MD, FACS Commissioner
More informationGlobal TB Burden, 2016 estimates
TUBERCULOSIS EPIDEMIOLOGY LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 216 estimates Total TB Estimated number of TB cases 1.4 million 14 per 1, Estimated
More informationThe Scaling-up of TB/HIV Collaborative Activities in the Asia-Pacific
Health System Strengthening and Sustaining the Response The Scaling-up of TB/HIV Collaborative Activities in the Asia-Pacific Jintana Ngamvithayapong-Yanai, Ph.D. On behalf of TB/HIV Working Group, the
More informationThe Public Health Impact of TB in the Correctional System. Sarah Bur, RN, MPH Federal Bureau of Prisons Infection Prevention and Control Officer
The Public Health Impact of TB in the Correctional System Sarah Bur, RN, MPH Federal Bureau of Prisons Infection Prevention and Control Officer The Public Health Impact of TB in the Correctional System
More informationTuberculosis 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
More informationThe United Nations flag outside the Secretariat building of the United Nations, New York City, United States of America
The United Nations flag outside the Secretariat building of the United Nations, New York City, United States of America Mike Segar / Reuters Executive Summary Context On 26 September 2018, the United Nations
More informationThe authors assessed drug susceptibility patterns
Drug Resistance Among Tuberculosis Patients, 1991 and 1992 New York City, CYNTHIA R. DRIVER, RN, MPH THOMAS R. FRIEDEN, MD, MPH ALAN B. BLOCH, MD, MPH IDA M. ONORATO, MD All the authors are with the Division
More informationTB, BCG and other things. Chris Conlon Infectious Diseases Oxford
TB, BCG and other things Chris Conlon Infectious Diseases Oxford Epidemiology Latent TB IGRA BCG >50/100000
More informationHaley Blake Sage Nagai, MPH. Disease Investigation and Intervention Specialists Tuberculosis Treatment and Control Clinic
Haley Blake Sage Nagai, MPH Disease Investigation and Intervention Specialists Tuberculosis Treatment and Control Clinic Discuss the prevalence of tuberculosis in Clark County Describe factors influencing
More informationWhen 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:
More informationThe Scaling-up of TB/HIV Collaborative Activities in the Asia-Pacific
Health System Strengthening and Sustaining the Response The Scaling-up of TB/HIV Collaborative Activities in the Asia-Pacific Jintana Ngamvithayapong-Yanai, Ph.D. On behalf of TB/HIV Working Group, the
More informationTUBERCULOSIS IN HEALTHCARE SETTINGS Diana M. Nilsen, MD, FCCP Director of Medical Affairs, Bureau of Tuberculosis Control New York City Department of
TUBERCULOSIS IN HEALTHCARE SETTINGS Diana M. Nilsen, MD, FCCP Director of Medical Affairs, Bureau of Tuberculosis Control New York City Department of Health and Mental Hygiene TODAY S PRESENTATION Epidemiology
More informationACTIVE TUBERCULOSIS IN MACOMB COUNTY, A Review of TB Program Data,
ACTIVE TUBERCULOSIS IN MACOMB COUNTY, 1996-2010 A Review of TB Program Data, 1996-2010 Prepared by: Janice M. Chang, MBBS, MPH Division Director, Health Promotion and Disease Control Macomb County Health
More informationSubstance Abuse and Tuberculosis Oklahoma City, Oklahoma November 17, 2010
Substance Abuse and Tuberculosis Oklahoma City, Oklahoma November 17, 2010 Epidemiology of Substance Abuse and Tuberculosis: Where is the Problem? Mary Long, MPSH; Heartland Phillip Lindsey, MD; OK State
More informationA Review on Prevalence of TB and HIV Co-infection
Human Journals Review Article May 2015 Vol.:1, Issue:1 All rights are reserved by Jyoti P. Waghmode et al. A Review on Prevalence of TB and HIV Co-infection Keywords: tuberculosis, HIV, co-infection, prevalence
More informationWHAT'S IN A NUMBER? TWO RECENT REPORTS ESTIMATING CHILDHOOD TB CASES.
WHAT'S IN A NUMBER? TWO RECENT REPORTS ESTIMATING CHILDHOOD TB CASES. Helen Jenkins, Peter Dodd, Andrea Cruz Instructor, Brigham and Women's Hospital, Boston, USA Research Associate, University of Sheffield,
More informationTuberculosis: 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.
More informationMathematical modelling approach to estimating TB burden in children Pete Dodd (University of Sheffield) & James Seddon (Imperial College London)
Mathematical modelling approach to estimating TB burden in children Pete Dodd (University of Sheffield) & (Imperial College London) Wednesday, 1 April 215 Health Economics & Decision Science School of
More informationEpidemiology of Tuberculosis Denver TB Course
Epidemiology of Tuberculosis Denver TB Course Randall Reves, MD, MSc Volunteer Clinician Denver Metro TB Program and Division of Infectious Diseases, Department of Medicine University of Colorado Denver
More informationYakima Health District BULLETIN
Yakima Health District BULLETIN Summary Volume 13, Issue 1 February, 2014 Tuberculosis in Yakima County The rate of active tuberculosis (TB) in Yakima County has declined by about two-thirds over the past
More informationTuberculosis 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
More informationIntensified TB case finding among PLHIV and vulnerable population Identifying contacts Gunta Kirvelaite
Intensified TB case finding among PLHIV and vulnerable population Identifying contacts Gunta Kirvelaite Riga East Clinical hospital, Centre for tuberculosis and lung diseases. Head of outpatient department.
More informationTB Intensive Minneapolis, Minnesota September 23-26, 2008
TB Intensive Minneapolis, Minnesota September 23-26, 2008 TB in the Foreign-Born Population: Background and Demographic Overview Marge Higgins, LSW September 24, 2008 TB in the Foreign-Born Population
More informationArizona Annual Tuberculosis Surveillance Report
Arizona Annual Tuberculosis Surveillance Report 2014 Table of Contents I. Executive Summary 1 II. Case Rates 3 III. Cases and Case Rates by Race and Ethnicity 4 IV. Cases by Gender 4 V. Cases and Case
More informationRecipients of development assistance for health
Chapter 2 Recipients of development assistance for health Both low- and middle-income countries are eligible for development assistance for health (DAH). In addition to income, burden of disease, which
More informationTuberculosis Screening and Targeted Testing of College and University Students: Developing a Best Practice Approach:
Tuberculosis Screening and Targeted Testing of College and University Students: Developing a Best Practice Approach: Lori A. Soos MA, BSN, RN, Niagara University Deborah Penoyer, MS, RN, SUNY Geneseo Learning
More informationCMH Working Paper Series
CMH Working Paper Series Paper No. WG5 : 8 Title Interventions to reduce tuberculosis mortality and transmission in low and middle-income countries: effectiveness, cost-effectiveness, and constraints to
More informationTB 2015 burden, challenges, response. Dr Mario RAVIGLIONE Director
TB 2015 burden, challenges, response Dr Mario RAVIGLIONE Director Addis Ababa, Ethiopia 11-13 November 2015 Overview TB basics TB burden & challenges Response: End TB Strategy DAY 1 What is TB? Definition
More informationManaging Complex TB Cases Diana M. Nilsen, MD, RN
Managing Complex TB Cases Diana M. Nilsen, MD, RN Director of Medical Affairs NYC Department of Health & Mental Hygiene Bureau of TB Control Case #1 You are managing a patient who was seen at a private
More informationFundamentals of Tuberculosis (TB)
TB in the United States Fundamentals of Tuberculosis (TB) From 1953 to 1984, reported cases decreased by approximately 5.6% each year From 1985 to 1992, reported cases increased by 20% 25,313 cases reported
More informationEPIDEMIOLOGY OF TUBERCULOSIS AND the IMPACT ON CHILDREN
EPIDEMIOLOGY OF TUBERCULOSIS AND the IMPACT ON CHILDREN Anneke C. Hesseling Professor in Paediatrics and Child Health Director: Desmond Tutu TB center Stellenbosch University 11 September 11 th International
More informationTB in California: Costs, Transmission, and Selecting from the Latent Pool
TB in California: Costs, Transmission, and Selecting from the Latent Pool Pennan Barry, MD, MPH Tuberculosis Control Branch California Department of Public Health California Tuberculosis Controller s Association
More informationTB Disease Prevalence Survey - Overview, why and how
TB Disease Prevalence Survey - Overview, why and how Ikushi Onozaki MD, MPH Team Leader, TB Prevalence Survey WHO Global Task Force on TB Impact Measurement Stop TB Department, WHO onozakii@who.int 3 strategic
More informationTB in Foreign Born and High Risk Populations
TB Nurse Case Management San Antonio, Texas December 8-10, 2009 TB in Foreign Born and High Risk Populations John J. Nava, M.D. December 9, 2009 Tuberculosis in High Risk Populations and the Foreign Born
More informationTuberculosis 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
More informationMain global and regional trends
I N T R O D U C T I O N Main global and regional trends Promising developments have been seen in recent years in global efforts to address the AS epidemic, including increased access to effective treatment
More informationOverview of the Presentation
Overview of the Presentation Definitions(TBCase, MDR-TB & XDR-TB) Global Tuberculosis (TB,HIV/TB,MDR & XDR)Scenario & Trend Risk factor for TB Natural history of TB Types of TB & Trends of Extra Pulmonary
More informationTreatment of Tuberculosis, 2017
Treatment of Tuberculosis, 2017 Charles L. Daley, MD National Jewish Health University of Colorado Health Sciences Center Treatment of Tuberculosis Disclosures Advisory Board Horizon, Johnson and Johnson,
More informationCopyright 2011 Joint United Nations Programme on HIV/AIDS (UNAIDS) All rights reserved ISBN
UNAIDS DATA TABLES 2011 Copyright 2011 Joint United Nations Programme on HIV/AIDS (UNAIDS) All rights reserved ISBN 978-92-9173-945-5 UNAIDS / JC2225E The designations employed and the presentation of
More information11/1/2017. Disclosures. Update In Tuberculosis, Indiana Outline/Objectives. Pathogenesis of M.tb Global/U.S. TB Burden, 2016
Disclosures Update In Tuberculosis, Indiana 2017 Bradley Allen, MD, PhD, FACP, FIDSA Indiana University School of Medicine Division of Infectious Diseases Roudebush VAMC Indianapolis Medical Consultant,
More informationMDR-TB and HIV co-infection in Eastern Europe. Francis Drobniewski MBBS PhD Professor of Global Health and Tuberculosis
MDR-TB and HIV co-infection in Eastern Europe Francis Drobniewski MBBS PhD Professor of Global Health and Tuberculosis f.drobniewski@imperial.ac.uk Conflict of interest In the last year I have been a consultant
More informationDrug-resistant Tuberculosis
page 1/15 Scientific Facts on Drug-resistant Tuberculosis Source document: WHO (2008) Summary & Details: GreenFacts Level 2 - Details on Drug-resistant Tuberculosis 1. What is tuberculosis and why is it
More informationTurning Off the Spigot Reducing Nosocomial Drug Resistant TB. Edward A. Nardell, MD Harvard Medical School/PIH Brigham & Women s Hospital
Turning Off the Spigot Reducing Nosocomial Drug Resistant Transmission Edward A. Nardell, MD Harvard Medical School/PIH Brigham & Women s Hospital is an airborne infection Every case of MDR/XDR prevented
More information#4 (Tuberculosis OR TB OR Pulmonary Tuberculosis OR Multi-Drug Resistant Tuberculosis OR MDR OR Extremely-Drug Resistant Tuberculosis or XDR)
DATABASE Cochrane Database of Systematic Reviews DATE 15 DECEMBER 2015 #1 Safety of Crucell Ad35/ AERAS-402 OR Effectiveness of Crucell Ad35/ Aeras-402 OR Safety of MVA85A/ Aeras-485 OR Effectiveness of
More informationDRUG-RESISTANT TUBERCULOSIS
DRUG-RESISTANT TUBERCULOSIS WHAT HAVE WE LEARNED? PAUL FARMER, MD, PHD HARVARD MEDICAL SCHOOL BRIGHAM AND WOMEN S HOSPITAL PARTNERS IN HEALTH INTERNATIONAL WORKSHOP ON MDR-TB BEIJING, PEOPLES REPUBLIC
More informationNew Jersey HIV/AIDS Epidemiologic Profile 2011
New Jersey HIV/AIDS Epidemiologic Profile 2011 HIV/AIDS in New Jersey New Jersey ranks 5th among 46 states with long-term namebased reporting in the rate of HIV (not AIDS) infection among adults and adolescents
More informationDANISH GUIDELINES FOR PREVENTION AND TREATMENT OF TB IN CHILDREN
DANISH GUIDELINES FOR PREVENTION AND TREATMENT OF TB IN CHILDREN Troels Lillebæk Director, Consultant, DMSc, DTM&H International Reference Laboratory of Mycobacteriology / WHO TB Supranational Reference
More informationNassau Queens PPS Community Profile
Nassau Queens PPS Community Profile Counties served: Nassau and Queens DEMOGRAPHICS 1 The total population of the two counties served by the Nassau Queens (Nassau University Medical Center) PPS is 3,631,203.
More informationTB 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
More informationTUBERCULOSIS. 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
More informationTB In Detroit 2011* Early TB: Smudge Sign. Who is at risk for exposure to or infection with TB? Who is at risk for TB after exposure or infection?
Those oral antibiotics are just not working! Inpatient Standards of Care & Discharge Planning S/He s in the Hospital: Now What Do I Do? Dana G. Kissner, MD TB Intensive Workshop, Lansing, MI 2012 Objectives:
More informationHIV Incidence Report, Sexually Transmitted Diseases, HIV and Tuberculosis Section, Epidemiology and Surveillance Unit
HIV Incidence Report, 2017 Sexually Transmitted Diseases, HIV and Tuberculosis Section, Epidemiology and Surveillance Unit Introduction (I) These two introduction slides provide a general context for the
More informationTB 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
More informationUpdate on the 2007 TB Technical Instructions. Adriene Rister TB Control Coordinator Mainely TB: April 14, 2011
Update on the 2007 TB Technical Instructions Adriene Rister TB Control Coordinator Mainely TB: April 14, 2011 Annual Estimate of Migrants Entering the U.S. Refugees: 50,000-70,000 Immigrants: ~1 million
More informationWhy can t we eliminate tuberculosis?
Why can t we eliminate tuberculosis? Neil W. Schluger, M.D. Professor of Medicine, Epidemiology and Environmental Health Sciences Columbia University Chief Scientific Officer World Lung Foundation Current
More informationWASHINGTON STATE COMMUNICABLE DISEASES OF PUBLIC HEALTH SIGNIFICANCE FOR THE CIVIL SURGEON
WASHINGTON STATE COMMUNICABLE DISEASES OF PUBLIC HEALTH SIGNIFICANCE FOR THE CIVIL SURGEON SCOTT LINDQUIST MD MPH WASHINGTON STATE DEPARTMENT OF HEALTH STATE EPIDEMIOLOGIST FOR COMMUNICABLE DISEASES FOREIGN-BORN
More informationTuberculosis Elimination
Tuberculosis Elimination Where We ve Been, Where We re Going Mark Lobato, MD New England TB Consultant Division of Tuberculosis Elimination Centers for Disease Control and Prevention Disclosures / Disclaimer
More informationWorld Health Organization 2013
World Health Organization 2013 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization,
More informationEpidemiology of Tuberculosis in the Northeast Region of the United States Surveillance Data Source. States included in the Northeast Region
Epidemiology of Tuberculosis in the Northeast Region of the United States 993-8 Marian R. Passannante, PhD UMDNJ-New Jersey Medical School UMDNJ-School of Public Health Epidemiologist, New Jersey Medical
More informationBronx Community Health Dashboard: HIV and AIDS
Bronx Community Health Dashboard: HIV and AIDS Created: 5/4/17 Last Updated: 3//19 See last slide for more information about this project. 1 Overview of HIV/AIDS in the Bronx Disparities exist in early
More information2013 Annual Report Tuberculosis in Fresno County. Department of Public Health
2013 Annual Report Tuberculosis in Fresno County Department of Public Health www.fcdph.org In 2013, provisional data indicates that tuberculosis (TB) affected 3.0 / 100,000 people in the United States
More informationDetection and Treatment of Tuberculosis in Correctional Facilities: Opportunities and Challenges
Detection and Treatment of Tuberculosis in Correctional Facilities: Opportunities and Challenges David Karol, MD, MA Bureau of Prisons, FMC Butner Duke University Medical Center June 26, 2013 No Disclosures
More informationGLOBAL TUBERCULOSIS REPORT EXECUTIVE SUMMARY
GLOBAL TUBERCULOSIS REPORT EXECUTIVE SUMMARY 2018 Context On 26 September 2018, the United Nations (UN) will hold its first highlevel meeting on tuberculosis (TB), at its headquarters in New York. The
More information2009 ANNUAL TUBERCULOSIS MORBIDITY REPORT
Tuberculosis Control Program- Chicago Department of Public Health 2009 ANNUAL TUBERCULOSIS MORBIDITY REPORT Rahm Emanuel Mayor Bechara Choucair, MD Commissioner Front cover: Mycobacterium tuberculosis
More information2014 TUBERCULOSIS FACT SHEET A Profile of Mecklenburg County Reported Cases
OVERVIEW T uberculosis (TB) is a disease caused by bacteria called Mycobacterium tuberculosis. TB usually affects the lungs, but it can also affect other parts of the body. TB is spread through the air
More information