global tb burden, 2016 estimates · tuberculosis epidemiology—local, state, national, global...
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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
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Global Impact of TB Deaths
Global tuberculosis report 2017. Geneva: World Health Organization
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Global tuberculosis report 2017. Geneva: World Health Organization
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Global tuberculosis report 2017. Geneva: World Health Organization
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Global tuberculosis report 2017. Geneva: World Health Organization
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Global tuberculosis report 2017. Geneva: World Health Organization
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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
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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
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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
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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.
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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.
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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.
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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
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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 (%
)
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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.
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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.
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Modeling Tuberculosis Trends in the USA, A. N. H ILL , J. E. BECERRA AND
K. G. CASTRO. Epidemiol. Infect. (2012), 140, 1862–1872
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https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm6711a2‐H.PDF
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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.
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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.
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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
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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
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