TB Notes Newsletter
No. 1, 2007
Surveillance, Epidemiology, and Outbreak
Investigations Branch Updates
Release of 2005 TB Surveillance Report
This year’s Annual Surveillance Report, Reported
Tuberculosis in the United
States, 2005, was released October 2006, and is
posted on the Internet. Hard copy versions were made available in mid November
2006. A new section of the report that was created this year contains information
on U.S.-affiliated Pacific Island
jurisdictions.
Statistical highlights of Reported Tuberculosis in the United States, 2005, include
the following:
- Updated case counts for each year from 1993 through 2004
- Change in calculation of case rates for 2005 using unrounded figures
- Case counts: 14,097 TB cases were reported to CDC from the 50 states and
the District of Columbia, representing
a 2.9% decrease from 2004
- 20 states reported increases in case counts
- California, New York, Texas, and Florida accounted
for 48% of the overall 2005 national case total
- For the second consecutive year, Hispanics (29%) exceeded non-Hispanic
blacks (28%) as the racial/ethnic group with the largest percentage of total
cases
- Blacks or African Americans represented 45% of TB cases in U.S.-born persons
and accounted for more than one fifth of the overall national case total
- Hispanics and Asians each represented 40% of TB cases in foreign-born
persons and together accounted for almost 45% of the overall national case
total
- Case rates: The TB case rate declined from 4.9 to 4.8 per 100,000 population,
representing a 3.8% decrease from 2004
- 12 states and DC reported rates above the national average
- 26 states met the definition for low incidence (<3.5 cases per 100,000
population)
- The TB case rate was 2.5 per 100,000 for U.S.-born persons and 21.9 for
foreign-born persons
- Asians and Native Hawaiians or Other Pacific Islanders continue to have
the highest case rate among all racial and ethnic groups
- Burden in the foreign-born: The proportion of all cases occurring in foreign-born
persons was 55%
- 22 states had >50% of total cases among foreign-born persons
- 6 states had >70% of total cases among foreign-born persons
- The top five countries of origin of foreign-born persons with TB were
Mexico, the Philippines,
Vietnam, India,
and China
- Drug resistance: The proportion of cases with primary multidrug-resistant
TB remained approximately 1.0%
Following are suggested citations for hard copy and online versions:
Hard copy: CDC. Reported Tuberculosis in the United States, 2005.
Atlanta, GA: U.S.
Department of Health and Human Services, CDC, September 2006.
Online: Centers for Disease Control and Prevention.
Reported
Tuberculosis in the United States, 2005 [online]. Atlanta, GA: U.S. Department of
Health and Human Services, CDC; 2006.
—Submitted by Sandy Althomsons, MA,
MHS, for the Surveillance Team
Div of TB Elimination
Update on Research Priorities of
the Tuberculosis Epidemiologic Studies Consortium
The Semiannual TBESC Advisory Review (STAR) is the
new process for making funding requests to DTBE for Tuberculosis Epidemiologic
Studies Consortium (TBESC) research. It is being implemented for the
first time in fiscal year (FY) 2007. As part of this process, the TBESC Research
Committee, in collaboration with TBESC member sites, DTBE Branch Chiefs and
the Associate Director for Science, and representatives from ACET
and NTCA, developed a list of research questions based on programmatically relevant
priorities in TB prevention and control. After an initial ranking of the research
questions (using a formal voting scheme), a conference call was held to share
perspectives on the ranked list of questions. This included a discussion of
ongoing research, in order to avoid duplication, and gaps in current knowledge.
The outcome of the call was a re-voting and a final prioritized list of questions.
The prioritized list is intended to provide guidance to TBESC and CDC investigators
as they develop research proposals in response to a request for applications
issued by DTBE for FY07 funds.
The top five research questions listed in priority
order are as follows:
-
What are the most important risk factors for TB among
African Americans?
-
What is the epidemiology of diabetes and TB (incidence/prevalence)?
What are the treatment outcomes of persons with TB and diabetes, and do
the outcomes differ from nondiabetics with TB?
-
Conduct a study of follow-ups on (1) new arrivals with
Class A and B, and (2) those who were placed on a multidrug TB regimen abroad
and come to U.S.
-
Conduct phase 4 surveillance of QFT implementation in
program settings: ability of QFT to define populations who will get sick
with TB.
-
Which specific contact investigation (CI) strategies—from
the CI guidelines or elsewhere—decrease secondary cases and increase the
proportion of infected or at-risk contacts who accept and complete treatment
of LTBI?
The research proposals developed in response
to the prioritized list of questions were due December 20, 2006. A face-to-face
meeting of the DTBE branch chiefs, ADS, and Director, the TBESC Research Committee, and a representative
from ACET and NTCA was held January
12, 2007. The purpose of the meeting was to discuss and rank the proposals.
The outcome will be a final ranking and funding recommendation to Dr. Ken
Castro. The list of priorities will be re-examined each year as part
of the ongoing STAR process.
—Reported
by Rachel Albalak, PhD
Div of TB Elimination
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