Top Banner
6/14/2018 1 TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated number of TB cases Estimated number of deaths Total TB 10.4 million 140 per 100,000 1.7 million^ 6.7 million males 1,070,000 in males 3.7 million females 601,000 in women 1.4 million children 253,000 in children HIV‐associated TB 1 million (10%) 374,000 (22%) Multidrug‐resistant TB MDR/RR 490,000 (4.1% of new TB) 600,000 (incl. RR‐TB) 240,000 (14%) ^Includes HIV/TB deaths Global tuberculosis report 2017. Geneva: World Health Organization
23

Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

Sep 26, 2020

Download

Documents

dariahiddleston
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Page 1: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

1

TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBALOffice of Communicable Disease Epidemiology

Global TB Burden, 2016 estimates

Estimated number of TB cases

Estimated number of deaths

Total TB 10.4 million140 per 100,000

1.7 million^

6.7 million males 1,070,000 in males

3.7 million females 601,000 in women

1.4 million children 253,000 in children

HIV‐associated TB 1 million (10%) 374,000 (22%)

Multidrug‐resistant TB MDR/RR

490,000 (4.1% of new TB)600,000 (incl. RR‐TB)

240,000 (14%)

^Includes HIV/TB deaths

Global tuberculosis report 2017. Geneva: World Health Organization

Page 2: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

2

Washington State Department of Health | 3

Global Impact of TB Deaths

Global tuberculosis report 2017. Geneva: World Health Organization

Washington State Department of Health | 4

Global tuberculosis report 2017. Geneva: World Health Organization

Page 3: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

3

Washington State Department of Health | 5

Washington State Department of Health | 6

Page 4: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

4

Washington State Department of Health | 7

Global tuberculosis report 2017. Geneva: World Health Organization

Washington State Department of Health | 8

Page 5: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

5

Washington State Department of Health | 9

Washington State Department of Health | 10

Global tuberculosis report 2017. Geneva: World Health Organization

Page 6: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

6

Washington State Department of Health | 11

Washington State Department of Health | 12

Page 7: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

7

Global tuberculosis report 2017. Geneva: World Health Organization

Washington State Department of Health | 14

Page 8: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

8

Washington State Department of Health | 15

Reported Tuberculosis (TB) Cases United States, 1982–2016*

*As of June 21, 2017.

0

5,000

10,000

15,000

20,000

25,000

30,000

1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

No. o

f cases

Year

Page 9: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

9

TB Case Rates,* United States, 2016

*Cases per 100,000; as of June 21, 2017.DC, District of Columbia; NYC, New York City (excluded from New York state)

≤2.9 (2016 national average)

>2.9

DC

NYC

TB Case Rates,* U.S.‐Affiliated Pacific Islands, 2016

*Cases per 100,000 population; as of June 21, 2017.

243.9

120.3

98.4

50.5

46.1

1.8

8.3

2.9

0 50 100 150 200 250 300

Marshall Islands

Federated States of Micronesia

Palau

Northern Mariana Islands

Guam

American Samoa

Hawaii

United States overall

Page 10: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

10

TB Case Rates* by Age Group, United States, 1993–2016

*Cases per 100,000 population; as of June 21, 2017.

0

5

10

15

20

1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

0– 4

15–24

25–44

45–64

≥65

5–14

Cases per 100,000 population

Age (yrs.)

TB Case Rates by Age Group and Sex, United States, 2016*

*Cases per 100,000 population; as of June 21, 2017.

Cases per 100,000 population

0

1

2

3

4

5

6

7

<5 5–14  15–24 25–44 45–64 ≥65

Male Female

Page 11: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

11

TB Case Rates by Race/Ethnicity,* United States, 2003–2016†

* All races are non‐Hispanic;  multiple race indicates two or more races reported for a person, but does not include persons of Hispanic/Latino origin.†  As of June 21, 2017.

Cases per 100,000 population

0

5

10

15

20

25

30

35

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

American Indian/Alaska NativeAsianBlack/African AmericanNative Hawaiian/Other Pacific IslanderWhiteHispanic/Latino

Number of TB Cases Among U.S.‐Born versus Non‐U.S.–Born Persons, United States, 1993–2016*

No. o

f cases

0

5,000

10,000

15,000

20,000

1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

U.S.‐born Non‐U.S.–born

Year*As of June 21, 2017.

Page 12: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

12

Trends in TB Cases Among Non‐U.S.–Born Persons,United States, 1993–2016*

0

10

20

30

40

50

60

70

80

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

Year

Number of cases Percentage of total casesPercentageNo. of cases

*As of June 21, 2017.

TB Case Rates Among U.S.‐Born versus Non‐U.S.–Born Persons, United States, 1993–2016*

Cases per 100,000 population

0

5

10

15

20

25

30

35

40

1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

U.S. overall U.S.‐born Non‐U.S.–born

Year

*As of June 21, 2017.

Page 13: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

13

Reported TB Cases by Origin and Race/Ethnicity*, United States, 2016†

U.S.‐born persons Non‐U.S.–born persons§

Hispanic/Latino31%

Asian48%

Black/African American 14%

Native Hawaiian/Pacific Islander 1%

White 5%

Multiple race1%

Hispanic/Latino21%

American Indian/Alaska Native4%

Asian5%

Black/African American

37%

Native Hawaiian/Pacific Islander1%

White31%

Multiple race1%

* All races are non‐Hispanic;  multiple race indicates two or more races reported for a person, but does not include persons of Hispanic/Latino origin.†  Percentages are rounded; as of June 21, 2017.§ American Indian/Alaska Native accounted for <1% of cases among non‐U.S.–born persons and are not shown.

Countries of Birth Among Non‐U.S.–Born Persons Reported with TB, United States, 2016

Mexico 19%

Philippines 12%

India 9%

Vietnam 8%China 6%

Guatemala 3%

Haiti 3%

Other countries 40%

*Percentages are rounded; as of June 21, 2017.

Page 14: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

14

Percentage of Non‐U.S.–Born Persons with TB,by Time of Residence in U.S. Before Diagnosis, 2016*

*  As of June 21, 2017. †  Non‐U.S.–born persons for whom information on length of residence in the United States before diagnosis is unknown or missing.

Percentage

0

20

40

60

80

100

Mexico Philippines India All other non‐U.S.–born

Unknown ≤12 mos. 1–4 years 5–9 years 10–19 years ≥20 years†

Primary Anti‐TB Drug Resistance, United States, 1993–2016*

*  As of June 21, 2017. Note: Based on initial isolates from persons with no prior history of TB; multidrug‐resistant TB (MDR‐TB) is defined as resistance to at least isoniazid and rifampin.

Resistan

t (%

)

0

2

4

6

8

10

1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

Isoniazid MDR‐TB

Year

Page 15: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

15

Estimated HIV Coinfection Among Persons Reported with TB, United States, 1993–2016*

Coinfection (%)

0

10

20

30

40

50

60

70

1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

All ages Ages 25–44 yrs

Year*  As of June 21, 2017. Note: Minimum estimates are based on reported HIV‐positive status among all TB patients in the age group.

Reporting of HIV Test Results Among Persons with TB, by Age Group, United States, 1993–2016*

*  As of June 21, 2017. 

Note: Includes persons with positive, negative, or indeterminate human immunodeficiency virus (HIV) test results and persons from California with co‐diagnosis of TB and acquired immunodeficiency syndrome (AIDS).  Rhode Island did not report HIV test results for years 1993–1997. HIV test results for Vermont are not included for years 2007–2013. HIV test results for California are not included for years 2005–2010.

0

20

40

60

80

100

1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

All ages Ages 25–44 yrs

Year

With test results (%

)

Page 16: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

16

TB Cases Reported Among Homeless Persons During the 12 Months Before Diagnosis, Ages ≥15 Years, United States, 

1993–2016*

0

2

4

6

8

0

500

1,000

1,500

1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

No. of cases Percentage of total cases

Year

No. of cases Percentage

*  As of June 21, 2017. Note: Homeless during the 12 months before TB diagnosis.

Definition for Tuberculosis Genotypingin the United States

Initial 12‐locus MIRU‐VNTR*: 223325173533

Spoligotype: 000000000003771

PCRType:

PCR00002

Additional 12‐locus MIRU‐VNTR (MIRU2): 444534423428†

+

GENType:

G00010

Sequentially assigned for each unique spoligotype and initial 12‐locus MIRU‐VNTR combination

Sequentially assigned for each unique spoligotype and 24‐locus MIRU‐VNTR combination

* Mycobacterial interspersed repetitive unit–variable number tandem repeat.† The complete set of 24 loci is referred to as 24‐locus MIRU‐VNTR and is used for GENType designation for genotype in the United States.

Page 17: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

17

52.6

68.4 70.1

80.8 81.686.9

91.6 94.2 94.9 95.9 96.7 97.1 96.4

0

10

20

30

40

50

60

70

80

90

100

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Proportion of culture confirm

ed TB 

cases genotyped

 (%)

National Tuberculosis Genotyping Surveillance Coverage* by Year: United States†, 2004–2016

National Goal, 94% §

* The proportion of positive cultures with at least one genotyped isolate.† Includes 50 states and the District of Columbia.§ For the year 2020, the national goal for TB genotyping surveillance coverage will change to 100%.

Number of County‐Based Tuberculosis Genotype Clusters* by Cluster Size, United States, 2014–2016

878

263

10543 25 26 14 10 37

0

200

400

600

800

1,000

2 casecluster

3 casecluster

4 casecluster

5 casecluster

6 casecluster

7 casecluster

8 casecluster

9 casecluster

≥10 case cluster

Number of Clusters

Number of Persons in Cluster* Genotype cluster is defined as two or more cases with matching spoligotype and 24‐locus MIRU‐VNTR (GENType) within a county  during the specified 3‐year time period.

Page 18: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

18

Washington State Department of Health | 35

Washington State Department of Health | 36

Page 19: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

19

Washington State Department of Health | 37

Modeling Tuberculosis Trends in the USA, A. N. H ILL , J. E. BECERRA AND 

K. G. CASTRO. Epidemiol. Infect. (2012), 140, 1862–1872 

Washington State Department of Health | 38

https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm6711a2‐H.PDF

Page 20: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

20

Incidence by Origin1 ─ WA; 2007-2016

1 U.S. Born includes birth within the continental U.S. or U.S. territory.

Proportional Disease Burden by Origin1 ─ WA; 2009-2017

1 U.S. Born includes birth within the continental U.S. or a U.S. territory.

Page 21: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

21

Average Incidence by Race/Ethnicity1 ─ WA; 2015-2017

1 AIAN - American Indian or Alaskan Native; NHPI - Native Hawaiian or Other Pacific Islander.

Disease Burden by Race/Ethnicity1 ─ WA; 2015-2017

1 AIAN - American Indian or Alaskan Native; NHPI - Native Hawaiian or Other Pacific Islander.

Page 22: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

22

Proportional Disease Burden by Race/Ethnicity and Origin1 ─ WA; 2015-2017

1 AIAN - American Indian or Alaskan Native; NHPI - Native Hawaiian or Other Pacific Islander.2 U.S. Born includes birth within the continental U.S. or a U.S. territory

Average Incidence by Age/Gender ─ WA; 2015-2017

Page 23: Global TB Burden, 2016 estimates · TUBERCULOSIS EPIDEMIOLOGY—LOCAL, STATE, NATIONAL, GLOBAL Office of Communicable Disease Epidemiology Global TB Burden, 2016 estimates Estimated

6/14/2018

23

Washington State Department of Health | 45

TB Case Counts and Rates, 2016Curry Center Intensive Participants

Case Count Rate (per 100,000)

Arizona 188 2.7

California 2062 5.3

Canada 1738 5.2

Colorado 64 1.2

Delaware 16 1.7

Georgia 302 2.9

Jamaica 103 4.5

Montana 4 0.4

New Mexico 39 1.9

Oregon 70 1.7

Country Profiles 2016: World Health Organization

Centers for Disease Control and Prevention (CDC). Reported Tuberculosis in the United States, 2016. Atlanta, GA

Washington State Department of Health | 46