There were 3.9% fewer reported cases of TB (tuberculosis) in the USA in 2010 than in 2009, according to data published by the Centers for Disease Control and Prevention (CDC). The authors say that although the average drop in TB rates was 3.8% annually during 2000-2008, the target of less than 0.1 case per 100,000 people was not met by 2010. In 2010 there were 3.6 cases per 100,000 people.
The proportion of foreign-born people in America who develop TB is 11 times greater compared to those born in the country.
The incidence of TB within America in different ethnic groups is as follows, compared to non-Hispanic Caucasians (whites):
- Hispanics – 7 times greater
- Non-Hispanic African-Americans – 8 times greater
- Asians – 25 times greater
Among those just born in the USA, non-Hispanic African-Americans are seven times as likely to develop TB than non-Hispanic whites, the report informs.
In order to address these disparities between foreign and US born individuals and between America’s ethnic groups, surveillance and enhanced TB control and prevention activities will need to persist long-term.
All health departments throughout the country currently report confirmed TB cases that meet the nation’s case definition electronically to the CDC. The reports include such details as the patient’s (self-identified) race, ethnicity, treatment data, and drug-susceptibility test results when available. The CDC gathers all the data, as well as the US Census population estimates to work out overall TB rates.
TB rates vary from state-to-state. In Maine the figure is 0.6 per 100,000, while in Hawaii it is 8.8. D.C. and 18 states had higher TB rates in 2010 than in 2009, while 32 states had lower rates. California, Florida, New York and Texas had over 500 cases each in 2010 – their 5,503 total accounted for 48.2% of all cases in the country.
The TB rate among US-born individuals dropped 3.7% in 2010 compared to 2009, and 74.9% compared with 1993. The TB rate among US-born people is 1.6 cases per 100,000 population.
The rate among foreign-born individuals also dropped in 2010 compared with 2009 (3.4% drop). The rate among foreign-born people is 18.1 per 100,000 population. Four countries accounted for about half of all TB cases associated with foreign birth: Vietnam 7.7%, India 8.6%, the Philippines 11%, and Mexico 23%.
There were more cases among Hispanics than any other ethnic group.
Among individuals with tuberculosis, about 95% of Asians, 75% of Hispanics, 34% of blacks, and 20% of whites were foreign-born.
8.6% of those with confirmed TB were also coinfected with HIV. This data is provisional because information from Vermont and California was not available.
113 cases were of MDR-TB (multidrug-resistant TB) in 2009.
MMWR March 25, 2011 / 60(11);333-337
R Pratt, S Price, R Miramontes, MPH, T Navin, MD, Div of TB Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; BK Abraham, MD, EIS Officer, CDC.
Written by Christian Nordqvist