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Trends in Tuberculosis

Trends in Tuberculosis. Highlights from 2008. County of San Diego Health and Human Services Agency Tuberculosis Control Branch. TB Case Rates* in San Diego County, California, and the U.S.,1985-2008. Cases per 100,000. *Cases per 100,000. .

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Trends in Tuberculosis

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  1. Trends in Tuberculosis Highlights from 2008 County of San Diego Health and Human Services Agency Tuberculosis Control Branch

  2. TB Case Rates* in San Diego County, California, and the U.S.,1985-2008 Cases per 100,000 *Cases per 100,000.

  3. Reported TB Cases by Age Group San Diego County, 2008 <5 yrs (2%) 65+ yrs (17%) 5 - 14 yrs (5%) 15 - 24 yrs (15%) 45 - 64 yrs (31%) 25 - 44 yrs (30%)

  4. TB Case Rates* by Age Group San Diego County, 2008 Cases per 100,000 *Cases per 100,000

  5. Reported TB Cases Race/Ethnicity San Diego County vs. U.S. United States, 2008* San Diego, 2008 White (9%) White (17%) Asian (31%) Asian (26%) Other (2%) Hispanic (52%) Hispanic (30%) Black (6%) Black (25%) All races are non-Hispanic. Other includes American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander and persons reporting two or more races. *National 2008 data are provisional.

  6. Number of TB Cases inU.S.-born vs. Foreign-born Persons San Diego County, 1998-2008 No. of Cases

  7. Countries of Birth for Foreign-born Persons with TB, San Diego County vs. United States United States, 2008* San Diego, 2008 Other (17%) Other (50%) Mexico (23%) India (3%) Mexico (47%) Vietnam (7%) Philippines (11%) Philippines (26%) Vietnam (8%) India (8%) *National 2008 data are provisional.

  8. Length of U.S. Residence Prior to TB Diagnosis, San Diego, 2008

  9. Completeness of HIV Test Results in Persons with TB by Age GroupSan Diego County, 1999-2008 % with Test Results Aged 18-55 All Ages

  10. Estimated HIV Coinfection in Persons Reported with TB, San Diego County1999-2008 % Coinfection Note: Minimum estimates based on reported HIV-positive status among all TB cases in the age group.

  11. Anti-TB Drug Resistance San Diego County, 1999-2008 % Resistant Isoniazid resistance defined as resistant to isoniazid, susceptible to rifampin but may be resistant to other drugs. MDR TB defined as resistant to at least isoniazid and rifampin.

  12. Multidrug-Resistant TBSan Diego County, 1999-2008 Multidrug-resistant TB (MDR TB) defined as resistant to at least isoniazid and rifampin.

  13. Number of MDR TB Cases inU.S.-born vs. Foreign-born Persons San Diego County, 1999-2008 No. of Cases

  14. Mycobacterium bovis • Modes of transmission: • Most common: consumption of unpasteurized dairy products • Other: person-to-person via inhalation of aerosolized organisms • Uniformly resistant to pyrazinamide

  15. Mycobacterium bovisSan Diego County, 2004-2008 129 (10%) of 1,255 culture-proven TB cases • 127 (98%) were Hispanic • 82 (64%) born in Mexico • 28 (22%) coinfected with HIV • 27 (21%) were children less than 15 years old • 57 (44%) had only extrapulmonary site

  16. Pediatric TB andMycobacterium bovisSan Diego County, 2004-2008 • 27 (53%) of 51 children <15 years old with culture-proven TB had M. bovis • 19 had cervical lymphadenopathy • 3 had pulmonary TB (2 also had peritoneal TB) • 2 had disseminated disease • 2 had TB meningitis • 1 had bone/joint TB • 26 of 27 were US-born Hispanic children

  17. Mode of Treatment Administration in Persons Reported with TB San Diego County, 1993-2007 Directly observed therapy (DOT); Self-administered therapy (SA)

  18. Completion of TB Therapy San Diego County, 2001-2007 * Percentage *Healthy People 2010 target: 90% completed in 1 yr or less.

  19. SummaryTB in San Diego County, 2008 • Since 2001, decreasing trend in case count and rate • Primarily reflects sustained decreases among 25-64 year olds and Hispanics • Large decrease among children <5 years old • More than 70% of cases were in persons born outside the U.S. • More than 1/3 of all cases were from Mexico • Nearly 10% of cases occur in persons coinfected with HIV • 1-2% of cases are multidrug-resistant • 10% of culture-proven cases have M. bovis • More than 95% of patients treated with DOT • At least 95% of patients complete treatment

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