Division of Tuberculosis EliminationCenters for Disease Control and Prevention

Tuberculosis in the United StatesNational Surveillance System

Highlights from 2003

Reported TB Cases United States, 1982-2003

Year

1983 1987 1991 1995 1999 2003

No

. of

Ca

ses

12,000

16,000

20,000

24,000

28,000

TB MorbidityUnited States, 1999-2003

Year Cases Rate*1999 17,531 6.42000 16,377 5.82001 15,989 5.62002 15,075 5.22003 14,874 5.1

*Cases per 100,000

TB Case Rates,* United States, 2003

< 3.5 (year 2000 target)

3.6 - 5.1

> 5.1 (national average)

D.C.

*Cases per 100,000

TB Case Rates* by Age Group United States, 1993-2003

0

5

10

15

20

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

<15 15-24 25-44 45-64 65+

Age Group (years)

Ca

ses

per

10

0,00

0

*Cases per 100,000.

Reported TB Cases by Age Group United States, 2003

25 - 44 yrs (34%)

<15 yrs(6%)

15 - 24 yrs(11%)

45 - 64 yrs (29%)

65+ yrs (20%)

TB Case Rates* by Age Group and Sex, United States, 2003

0

5

10

15

<15 yrs 15-24 yrs 25-44 yrs 45-64 yrs 65+ yrs

Male Female

Ca

ses

per

10

0,00

0

*Cases per 100,000.

0

10

20

30

40

50

1993 1995 1997 1999 2001 2003

TB Case Rates* by Race/Ethnicity** United States, 1993-2003

Ca

ses

per

10

0,00

0

WhiteBlackHispanic

American Indian/Alaska NativeAsian/Pacific Islander

*Cases per 100,000.**All races are non-Hispanic. In 2003, Asian/Pacific Islander category includes persons who reported race as Asian only and/or Native Hawaiian or Other Pacific Islander only.

Reported TB Cases by Race/Ethnicity* United States, 2003

Hispanic or Latino(28%)

Black or African American(28%)

Asian(23%)

White(19%)

American Indian or Alaska Native (1%)

Native Hawaiian orOther Pacific Islander (1%)

*All races are non-Hispanic. Persons reporting two or more races comprised less than 1% of all cases.

TB Case Rates* by Age Group and Race/Ethnicity,** United States, 2003

0

20

40

60

80

100

<5 5-14 15-24 25-44 45-64 65+

Cas

es p

er 1

00,0

00

Age Group (yrs)

*Cases per 100,000.**All races are non-Hispanic. Persons reporting two or more races comprised less than 1% of all cases.

American Indian/Alaska NativeAsian

Black or African American

Hispanic or Latino

White

Native Hawaiian/Other Pacific Islander

Number of TB Cases inU.S.-born vs. Foreign-born Persons

United States, 1993-2003

0

5000

10000

15000

20000

1993 1995 1997 1999 2001 2003

U.S.-born Foreign-born

No

. o

f C

ases

Trends in TB Cases in Foreign-born Persons, United States, 1986-2003

0

2,000

4,000

6,000

8,000

10,000

86 87 88 89 90 91 92 93 94 95 96 97 98 990

10

20

30

40

50

60

No. of Cases Percentage of Total Cases

No. of Cases Percentage

00 01 02 03

Reported TB Cases by Origin and Race/Ethnicity,* United States, 2003

*All races are non-Hispanic. Persons reporting two or more races comprised less than 1% of all cases.**American Indian or Alaska Native and Native Hawaiian or Other Pacific Islander comprised less than 1% of foreign-born cases and are not shown.

U.S.-born Foreign-born**

Native Hawaiian/OtherPacific Islander (1%)

White (34%)

Black or African American (45%)

Hispanic or Latino (15%)

Asian (2%)American Indian or Alaska Native (3%)

Hispanic or Latino (39%)

Black or African American (13%)

Asian (42%)

White (5%)

Percentage of TB Cases Among Foreign-born Persons, United States

>50%25% - 49%<25%

1993 2003

DC DC

TB Case Rates* in U.S.-born vs. Foreign-born Persons

United States, 1993-2003

0

10

20

30

40

1993 1995 1997 1999 2001 2003

U.S. Overall U.S.-born Foreign-born

Cas

es p

er 1

00,0

00

*Cases per 100,000

TB Case Rates* in U.S.-born vs. Foreign-born Persons

United States, 1993-2003**

1

10

100

1993 1995 1997 1999 2001 2003

U.S. Overall U.S.-born Foreign-born

Cas

es p

er 1

00,0

00

*Cases per 100,000**Includes the same data as slide 15, but rates presented on a logarithmic scale.

Countries of Birth for Foreign-born Persons Reported with TB

United States, 2003

Mexico(26%)

Philippines(12%)

Viet Nam(8%)India

(8%)

China(5%)

Haiti(3%)

S. Korea(2%)

OtherCountries

(36%)

Length of U.S. Residence Prior to TB Diagnosis, United States, 2003

0%

20%

40%

60%

80%

100%

All Mexico Philippines Viet Nam

<1 yr 1- 4 yrs >5 yrs

Primary Anti-TB Drug Resistance United States, 1993-2003

0

5

10

1993 1995 1997 1999 2001 2003

Isoniazid MDR TB

% R

esis

tan

t

Note: Based on initial isolates from persons with no prior history of TB.MDR TB defined as resistance to at least isoniazid and rifampin.

Primary MDR TBUnited States, 1993-2003

0

100

200

300

400

500

93 94 95 96 97 98 99

0

1

2

3

No. of Cases Percentage

Note: Based on initial isolates from persons with no prior history of TB. MDR TB defined as resistance to at least isoniazid and rifampin.

No. of Cases Percentage

00 01 02 03

Primary Isoniazid Resistance in U.S.-born vs. Foreign-born Persons

United States, 1993-2003

02468

101214

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

U.S.-born Foreign-born

Pe

rce

nta

ge

Note: Based on initial isolates from persons with no prior history of TB.

Primary MDR TB inU.S.-born vs. Foreign-born

Persons, United States, 1993-2003

0

1

2

3

1993 1995 1997 1999 2001 2003

U.S.-born Foreign-born

% R

esis

tan

t

Note: Based on initial isolates from persons with no prior history of TB.MDR TB defined as resistance to at least isoniazid and rifampin.

% w

ith

Tes

t R

es

ult

s

Note: Includes cases with positive, negative, or indeterminate HIV test results and cases from California in persons reported with AIDS (HIV test results are not reported from California).

Completeness of HIV Test Results in Persons with TB by Age Group

United States, 1993-2002

010203040506070

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

All Ages Aged 25 - 44

Estimated HIV Coinfection in Persons Reported with TB, United States,

1993-2002

0

10

20

30

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

All Ages Aged 25 - 44

% C

oin

fect

ion

Note: Minimum estimates based on reported HIV-positive status among all TB cases in the age group.

Mode of Treatment Administration in Persons Reported with TB

United States, 1993-2001

0%

20%

40%

60%

80%

100%

1993 1994 1995 1996 1997 1998 1999 2000 2001

DOT only DOT + SA SA only

Directly observed therapy (DOT); Self-administered therapy (SA)

Completion of TB Therapy United States, 1993-2001

0

20

40

60

80

100

1993 1994 1995 1996 1997 1998 1999 2000 2001

Completed Completed in 1 yr or less

*Healthy People 2010 target: 90% completed in 1 yr or less.Note: Persons with initial isolate resistant to rifampin and children under 15 years old with meningeal, bone or joint, or miliary disease excluded.

Per

cen

tag

e

*