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Online Tuberculosis Information System (OTIS) Online Tuberculosis Information System Summary Summary Disease Incidence:   The Online Tuberculosis Information System (OTIS) contains information on verified tuberculosis (TB) cases reported to the Centers for Disease Control and Prevention (CDC) by state health departments, the District of Columbia and Puerto Rico from 1993 through 2007. These data were extracted from the CDC national TB surveillance system. Data for 22 variables are included in the data set and users are able to produce cross-tabulations with multi-level stratification. Each year these data are updated with an additional year of cases plus revisions to cases reported in previous years. See OTIS Technical Reference for more details. Population:   All persons reported as TB cases, 1993 through 2007. The 1993-2007 data includes case report updates received before April 23, 2008. Source Tuberculosis Reports:   U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination (DTBE), Surveillance, Epidemiology and Outbreak Investigations Branch (SEOIB). Population Estimates for Rates:   National population denominators for the years 1993-2007 are from the National Center for Health Statistics "bridged-race" series of estimates. The postcensal population estimates for 2000-2007 resident population are based on the Census 2000 counts, and were prepared under a collaborative arrangement with the U.S. Census Bureau. The intercensal population estimates for 1990-1999 incorporate the bridged-single-race estimates of the April 1, 2000 resident population, and were prepared by the U.S. Census Bureau with support from the National Cancer Institute. See Population Sources below for more information. In WONDER You can produce tables, maps, charts, and data extracts. Obtain incidence counts and rates, show the percentage of cases that have completed therapy in less than 1 year of diagnosis, and the percentage of culture-confirmed cases with drug susceptibility testing to isoniazid (INH) and rifampin (RIF). Select specific disease, demographic and risk factor criteria to produce cross-tabulated incidence measures. Data are organized into three levels of geographic detail: national, state and Metropolitan Statistical Areas (MSAs). The population estimates used as the denominator for rate calculations are also shown. (Note: drug susceptibility testing measures and variables, and state rates are available only for vintage 2005 data and later.) You can limit and index your data by any and all of these variables: Location - National, State, Metropolitan Statistical Area (MSA) Year - 1993-2007, or the last 5 years combined (2003-2007 in the 2007 data) Age Groups - 2 sets of age groups are available, Broad and Standard Sex - All, Female, Male, Not Reported Race / Ethnicity - Hispanic or Latino, Non-Hispanic (NH) racial categories for American Native, Asian / Pacific Islander, Black, White, Not Reported. Occupation - Correctional, Health care, Migratory Agricultural, Multiple, Not Employed, Other, Not Reported. Place of Birth - U.S. Born, Foreign Born, Not Reported Years in U.S. - Under 1 year, 1-4 years, 5-14 years, 15 or more years, Not Reported HIV Status - Postive, Negative, Not Reported Homeless in the Past Year? - Yes, No, Not Reported Residing in a Correctional Facility? - Yes, No, Not Reported Residing in a Long Term Care Facility? - Yes, No, Not Reported Place of Residence at Diagnosis? - Correctional Facility, Long Term Care Facility, Other, Not Reported Alcohol Use - Yes, No, Not Reported Drug Use, Injecting - Yes, No, Not Reported Drug Use, Non-injecting - Yes, No, Not Reported Disease Site - Pulmonary, Extrapulmonary, Both, Not Reported Multidrug-Resistant - Yes, No, Not Reported Previous TB - Yes, No, Not Reported Verification Criteria - Positive Culture, Positive Smear or Tissue, meets Clinical Case Definition, Provider Diagnosis Receives Directly Observed Therapy? - Directed therapy Only, Self-administered Only, Both, Not Reported Completion of Therapy within 1 year - No, Yes, Not Applicable Tested for Isoniazid Susceptibility - No, Yes, Not Applicable (vintage 2005 and later only) Tested for Isoniazid & Rifampin Susceptibility - No, Yes, Not Applicable (vintage 2005 and later only) Vital Status - Alive, Dead, Not Reported Please refer to the following topics: OTIS Data Request Data Source Information Additional Information OTIS Data Request Output You can produce tables, maps, charts, and data extracts. Obtain incidence Counts and rates, show the percentage of cases that have completed therapy in less than 1 year of diagnosis, and and the percentage of culture-confirmed cases with drug susceptibility testing to isoniazid (INH) and rifampin (RIF). Select specific disease, demographic and risk factor criteria to produce cross-tabulated incidence measures. (Note: drug susceptibility testing measures and variables, and state rates are available only for vintage 2005 data and later.) Variables You can limit and index your data by any and all of these variables: Location - National, State, Metropolitan Statistical Area (MSA) Year - 1993-2007, or the last 5 years combined (2003-2007 in the 2007 data) Age Groups - 2 sets of age groups are available, Broad and Standard Sex - All, Female, Male, Not Reported Race / Ethnicity - Hispanic or Latino, Non-Hispanic (NH) racial categories for American Native, Asian / Pacific Islander, Black, White, Not Reported. Occupation - Correctional, Health care, Migratory Agricultural, Multiple, Not Employed, Other, Not Reported. Place of Birth - U.S. Born, Foreign Born, Not Reported Years in U.S. - Under 1 year, 1-4 years, 5-14 years, 15 or more years, Not Reported HIV Status - Postive, Negative, Not Reported Homeless in the Past Year? - Yes, No, Not Reported Residing in a Correctional Facility? - Yes, No, Not Reported Residing in a Long Term Care Facility? - Yes, No, Not Reported Place of Residence at Diagnosis? - Correctional Facility, Long Term Care Facility, Other, Not Reported Alcohol Use - Yes, No, Not Reported Drug Use, Injecting - Yes, No, Not Reported Drug Use, Non-injecting - Yes, No, Not Reported Disease Site - Pulmonary, Extrapulmonary, Both, Not Reported Multidrug-Resistant - Yes, No, Not Reported Previous TB - Yes, No, Not Reported Verification Criteria - Positive Culture, Positive Smear or Tissue, meets Clinical Case Definition, Provider Diagnosis Receives Directly Observed Therapy? - Directed therapy Only, Self-administered Only, Both, Not Reported Completion of Therapy within 1 year - No, Yes, Not Applicable Tested for Isoniazid Susceptibility - No, Yes, Not Applicable (vintage 2005 and later only) Tested for Isoniazid & Rifampin Susceptibility - No, Yes, Not Applicable (vintage 2005 and later only) Vital Status - Alive, Dead, Not Reported How? The Request screen has sections to guide you through making a data request as step-by-step process. However, to get your first taste of how the system works, you might want to simply press any Send button, and execute the default data request. The data results for your query appear on the Table screen. After you get your data results, try the Chart and Map screens. Or export your data to a file (tab-delimited line listing) for download to your computer. For more information, see the following: Quick Start Guide; Step 1, Select and order results; Step 2, Select location and time; Step 3, Select demographics; Step 4, Select risk factors; Step 5, Select disease citeria; Step 6, Select therapy issues; Step 7, Other Options. 'By-Variables' Select variables that serve as keys (indexes) for organizing your data. See How do I organize my data? for more information. Note:   To map your data, you must select at least one geographical location as a "By-Variable" for grouping your data, such as Region or State. Help Click on any button labled "Help", located to the right hand side of the screen at the top of each section. Each Control's label, such as the "Location" label next to the Location entry box, is linked to the on-line help for that item. Send Sends your data request to be processed on the CDC WONDER databases. The Send buttons are located on the bottom of the Request page, and also in the upper right corner of each section, for easy access. Step 1. Organize table layout: Group Results By   Select up to five variables that serve as keys for grouping your data. See Group Results By below for hints. Include Completion of Therapy   Select the checkbox to report the percentage of cases that completed therapy in less than 366 days of diagnosis. Include Rates   Select the checkbox to report the percentage of culture confirmed cases with test results for Isoniazid susceptibility. (Note: are optional for vintage 2005 and later only, and state rates are available only for vintage 2005 and later data.) Include Drug Susceptibility Testing for Isoniazid (INH)   Select the checkbox to report the percentage of culture confirmed cases with test results for Isoniazid susceptibility. (Note: drug susceptibility testing measures are available only for vintage 2005 and later.) Include Drug Susceptibility Testing for Isoniazid (INH) and Rifampin (RIF)   Select the checkbox to report the percentage of culture confirmed cases with test results for Isoniazid and and Rifampin susceptibility. (Note: drug susceptibility testing measures are available only for vintage 2005 and later.) Title   Enter any desired description to display as a title with your results. The following statistical measures are available as query results: Disease Incidence Counts Disease Incidence Rates for national data, and for state data in vintage 2005 and later. Percent of total data data results Completion of Therapy (COT): percentage of cases that completed therapy in less than 366 days of diagnosis Percentage Tested for Drug Susceptibility to Isoniazid (INH) : percentage of culture confirmed cases reporting test results (vintage 2005 and later only) Percentage Tested for Drug Susceptibility to Isoniazid (INH) and Rifampin (RIF): percentage of culture confirmed cases reporting test results (vintage 2005 and later only) Group Results By... Select up to five variables that serve as keys for grouping your data. For example, you could select to group (summarize, stratify, index) your data by Location (State or MSA) and Verification Criteria. How?    See How do I organize my data? for more information. Hints:    To make a map, you must request data with a geographic location variable, such as Region or State, as a "By-Variable." Then click the Map tab. You cannot make charts when your data has more than two By-Variables. You cannot group the data by both State and by MSA. You can group by State only when you have chosen State locations. You can group by MSA only when you have chosen MSA locations. You cannot group the data by Year when specific Risk-Factor or Demographic data values are shown. You cannot group the data by specific Risk-Factor or Demographic data values, unless the requested time period is "All Years" or the last 5 years (2003-2007 in 2007 data, 2002-2006 in the 2006 data, 2001-2005 in the 2005 data, 2000-2004 in the 2004 data, or 1999-2003 in the 2003 data). When rates are calculated, you can only group the data by those variables that have population denominator data, such as Age Group, Sex, Race, and Year. Note that these 4 variables with population denominator data are also the only variables that you can limit or restrict when calculating rates. Percent Percent is a column reported in the output for your data query. The Percent column shows the percentage of each row's cases in comparison to the total data results for your query. The sum of the column is 100%, all results for your data request. Counts Count is a column reported in the output for your data query. A case is counted only once within any consecutive 12-month period. However, a patient who had verified disease in the past is counted again if the case was discharged from supervision (e.g., completed antituberculosis therapy) or lost to supervision for more than 12 months and disease can be verified again. The case is not counted a second time if 12 months have not passed since the case was discharged from supervision. Mycobacterial diseases other than those caused by M. tuberculosis complex are not counted in tuberculosis morbidity statistics unless there is concurrent M. tuberculosis. CDC's national morbidity reports have traditionally counted all cases; those that meet the standard published case definition and those that are verified by the reporting areas. When the standard case definition is not met, areas are given the option of verifying using other sets of local criteria such as contact to an infectious case or immunosuppression status. In this circumstance, the criteria used to verify the case of TB are categorized as "Provider Diagnosis." For more information, see Recommendations for Counting Reported Tuberculosis Cases from http://www.cdc.gov/tb/surv/. Rates Rate is a column reported in the output for your data query. Rates are expressed as the number of cases reported each calendar year per 100,000 population and are only available in OTIS for national level data. Population denominators used to calculate national and state rates for the years 1993-2007 were obtained from the National Center for Health Statistics bridged-race population counts. See Population Sources for more information. Notes: When rates are calculated, you can only group the data by those variables that have population denominator data, such as Age Group, Sex, Race, and Year. Note that these 4 variables with population denominator data, Age Group, Sex, Race, and Year, are also the only variables that you can limit or restrict when calculating rates. Rates are only available for national-level data for the vintages prior to 2005. State rates are available for vintage 2005 data and later years. For example, when the selected location is "The United States" and the data results are not grouped by State or grouped by MSA, then rates are shown. If each of the 50 states plus the District of Columbia (DC) is selected in the State list, then the national rate is shown. However, if Puerto Rico is included (select every option but "The United States" in the State list), then rates are not shown. Completion of Therapy (COT) in less than one year - percentage measure Completion of Therapy data are available both as a percentage measure as a categorical variable. The Completion of Therapy percentage measure is a column reported in the output for your data query, when you check the box on the Request form for this measure. Completion of Therapy (COT) indicates if the patient completed TB therapy in less than 366 days of diagnosis, for patients with "uncomplicated" TB. Completion of Therapy (COT) in OTIS refers to completion of anti-TB drug therapy for an "uncomplicated" patient within 366 days of diagnosis. COT is typically shown as a percentage or proportion of TB cases that complete therapy within one year (less than 366 days) and have met several criteria (see detailed criteria in next paragraph). In order to determine whether a case is "uncomplicated," TB cases are stratified by the indicated length of therapy, based on American Thoracic Society/CDC treatment guidelines 14,15 in effect during the period covered, and the patients initial drug susceptibility test results, age, and site of disease. The adequacy of the treatment regimen (e.g., the sufficiency of the duration of therapy, the appropriateness of the prescribed TB drugs) are not part of the calculation of COT. Acquired drug resistance during therapy with the need for a longer duration of therapy is also not considered. The determination of the indicated length of therapy for 1 year or less is based on a number of factors. Patients with an initial M. tuberculosis isolate resistant to rifampin and pediatric patients (less than 15 years old) with miliary disease or a positive blood cluture require therapy for greater than 366 days and are therefore not included in the calculations of COT appearing on OTIS. For all other patients, including those with culture-negative disease, those with an unknown culture status, and those with culture-positive disease, but unknown initial drug susceptibility test results, data were included in the calculation of COT for those with 1 year or less of therapy indicated. The number of cases (i.e., denominator) used to calculate the percentage of those receiving COT includes patients meeting the following criteria: 1) had an indicated length of therapy of 1 year or less, 2) were alive at diagnosis and prescribed an initial regimen of one or more drugs, and 3) did not die during therapy. The percentage of COT was calculated by dividing the number of patients reported as having completed therapy in 1 year or less by the total number of cases in the denominator. The number of patients included in the calculation is reported in the Completion of Therapy categorical variable. Check the box on the Request form to show Completion of Therapy (COT) in your results. How?    See How do I change a "CheckBox?" for more information. Notes: Due to treatment-related reporting delays, Completion of Therapy (COT) data and Directly Observed Therapy (DOT) data are reported from 1993 through two (2) years preceding the last year of data included in the dataset. States have up to two years to report these types of data, thus the case evidence lags 2 years behind the current report year. For example: the Vintage 2007 OTIS dataset reports Completion of Therapy for the years 1993-2005; the Vintage 2006 OTIS dataset reports Completion of Therapy for the years 1993-2004; the Vintage 2005 OTIS dataset reports Completion of Therapy for the years 1993-2003; the Vintage 2004 OTIS dataset reports Completion of Therapy for the years 1993-2002; the Vintage 2003 OTIS dataset reports Completion of Therapy for the years 1993-2001. "Not Applicable" is displayed for the Completion of Therapy (COT) value when the data includes: case reports with an initial M. tuberculosis isolate resistant to rifampin; patients with meningeal disease; pediatric patients (less than 15 years old) with miliary disease; pediatric patients (less than 15 years old) with a positive blood culture; patients that were not alive at diagnosis, and patients that died during therapy; case reports where the "Vital Status" value is "Dead." case reports within the 2 year period preceding the "Vintage" year of the data set, which is the final year included in the data set, also known as the current reporting year. The criteria for the COT calculation changed with OTIS 2006 and later years: previous data releases included patients over age 15 with meningeal disease and pediatric patients with positive blood cultures, and excluded pediatric patients with bone or joint disease. OTIS displays Completion of Therapy (COT) data as a percentage measure and as a categorical variable. In the previous annual data sets for years before vintage 2005, Completion of Therapy (COT) is displayed as a percentage measure only, and not as a categorical variable. Drug Susceptibility Testing There are two measures that show the percentage of case reports that indicate that the patient was tested for drug susceptibility: Percentage Tested for Susceptibility to Isoniazid (INH): percentage of culture confirmed cases reporting test results Percentage Tested for Susceptibility to Isoniazid (INH) and Rifampin (RIF): percentage of culture confirmed cases reporting test results There are also two variables that show whether the case report indicates if the patient was tested for drug susceptibility: Tested for Isoniazid Susceptibility - No, Yes, Not Applicable Tested for Isoniazid & Rifampin Susceptibility - No, Yes, Not Applicable Note:  the drug susceptibility testing data are available only for vintage 2005 data and later. Drug Susceptibility Testing for Isoniazid (INH) Drug Susceptibility Testing for Isoniazid (INH) data are available both as a measure and as a Disease Critera variable. Measure of the percentage of cases with drug susceptibility testing: "Percentage tested for drug susceptibility to Isoniazid (INH)" is a column reported in the output for your data query, when you check the box on the Request form for this measure. This measure reports the percentage of culture confirmed cases with test results for Isoniazid susceptibility. Check the box on the Request form to show Percentage Tested for Susceptibility to Isoniazid (INH) in your results. How?    See How do I change a "CheckBox?" for more information. Notes: The measure indicates the percentage of cases where drug susceptibility testing results were included in the case report (susceptible or resistant) to at least Isoniazid (INH). The percentage is calculated from the ratio of culture-confirmed cases with drug susceptibility testing results divided by all culture confirmed cases: Number of culture-confirmed cases with results / Number of culture-confirmed cases The numerator includes all culture-confirmed cases with reported test results that meet the query criteria. The denominator includes all counted, culture-confirmed cases meeting the query criteria. The drug susceptibility testing data are available only for vintage 2005 data and later years. Drug Susceptibility Testing for Isoniazid (INH) and Rifampin (RIF) Drug Susceptibility Testing for Isoniazid (INH) and Rifampin (RIF) data are available both as a measure and as a Disease Critera variable. Measure of the percentage of cases with drug susceptibility testing: "Percentage Tested for Susceptibility to Isoniazid (INH) and Rifampin (RIF)" is a column reported in the output for your data query, when you check the box on the Request form for this measure. This measure reports the percentage of culture confirmed cases with test results for both Isoniazid and Rifampin susceptibility. Check the box on the Request form to show Percentage Tested for Susceptibility to Isoniazid & Rifampin in your results. How?    See How do I change a "CheckBox?" for more information. Notes: The measure indicates the percentage of cases where drug susceptibility testing results were included in the case report (susceptible or resistant) to both Isoniazid (INH) and Rifampin (RIF). The percentage is calculated from the ratio of culture-confirmed cases with drug susceptibility testing results divided by all culture confirmed cases: Number of culture-confirmed cases with results / Number of culture-confirmed cases The numerator includes all culture-confirmed cases with reported test results that meet the query criteria. The denominator includes all counted, culture-confirmed cases meeting the query criteria. The drug susceptibility testing data are available only for vintage 2005 data and later years. Step 2. Select location and years: Location Pick any combination of locations desired, from either the State or the MSA lists, but not both. Be sure the button for State or MSA is set to your choice. How?   See How do I select items from the list box? and also see How do I change a "CheckBox?" A "Radio Button?" to pick your preferred location list. Notes:   State and MSA data are based on the patient's residence at the time of TB diagnosis. "The United States" in the State list does not include Puerto Rico. Select everything but "The United States" to use all the states plus Puerto Rico. State Select the United States or any combination of individual states. Be sure the radio button above the State list is selected. The values for this data element includes all states, the District of Columbia, and Puerto Rico. How?   See How do I select items from the list box? and also see How do I change a "CheckBox?" A "Radio Button?" to pick your preferred location list. Notes:   State and MSA data are based on the patient's residence at the time of TB diagnosis. "The United States" in the State list does not include Puerto Rico. Select everything but "The United States" to use all the states plus Puerto Rico. Privacy concerns: In order to protect personal privacy, demographic and risk-factor information is limited to the national level for individual years of data. Select either "All Years" or the last 5 years ("2003-2007" in the vintage 2007 data) if you wish to request specific demographic and/or risk-factor information for a specific State or MSA. "grouped by" State or MSA, because a row for each location is shown. All metropolitan data values representing less than 5 cases are marked "Suppressed." All state data values representing less than 5 cases are suppressed, unless the total cases for a state are shown for 1 or more years combined. National data are not suppressed, nor when the total number of cases (no sub-sets) for a state is shown, such as the single culture-confirmed case in Wyoming in 1999. Note that for data released prior to October 31, 2007, for OTIS data vintages 2004 and 2003, values representing cases counts less than or equal to 3 are suppressed for state data unless the total cases in 1 year are shown, and values less than 4 are suppressed for all metropolitan data. All HIV data from the state of Louisiana are suppressed when shown at the state or metropolitan (MSA) level. HIV data for Louisiana is included at the national level. Rates are available for national and state-level data in OTIS vintages 2006 and 2005. Previous OTIS vintages 2004 and 2003 only provided rates for national data. The table below shows the Federal Information Processing Standard (FIPS) code value for each state and the state's name, as specified for data export. FIPS Code State Name 01 Alabama 02 Alaska 04 Arizona 05 Arkansas 06 California 08 Colorado 09 Connecticut 10 Delaware 11 District of Columbia 12 Florida 13 Georgia 15 Hawaii 16 Idaho 17 Illinois 18 Indiana 19 Iowa 20 Kansas 21 Kentucky 22 Louisiana 23 Maine 24 Maryland 25 Massachusetts 26 Michigan 27 Minnesota 28 Mississippi 29 Missouri 30 Montana 31 Nebraska 32 Nevada 33 New Hampshire 34 New Jersey 35 New Mexico 36 New York 37 North Carolina 38 North Dakota 39 Ohio 40 Oklahoma 41 Oregon 42 Pennsylvania 44 Rhode Island 45 South Carolina 46 South Dakota 47 Tennessee 48 Texas 49 Utah 50 Vermont 51 Virginia 53 Washington 54 West Virginia 55 Wisconsin 56 Wyoming 72 Puerto Rico Metropolitan Statistical Area (MSA) Select the United States or any combination of individual MSAs. Be sure the radio button above the MSA list is highlighted. The values in this data field are MSAs with a population greater than or equal to 500,000 persons for at least one year during the reporting period, 1993-2007. (See list below). How?   See How do I select items from the list box? and also see How do I change a "CheckBox?" A "Radio Button?" to pick your preferred location list. Notes:    Metropolitan statistical areas are defined by the federal Office of Management and Budget (OMB). The MSA definitions apply to all areas except the six New England states; for these states, the New England County Metropolitan Areas (NECMAs) are used. Metropolitan areas are named for a central city in the MSA or NECMA, may include several cities and counties, and may cross state boundaries. Further information about MSAs can be found on the U.S. Census Bureau website at www.census.gov, search for "Metropolitan Statistical Area". In order to protect personal privacy: Demographic and risk-factor information is limited to the national individual years of data. Also, all values less than or equal to 3 are suppressed, unless shown at the national level, or unless the total cases for state are shown for a period of one or more years of data combined. Select either "All Years" or the last 5 years ("2003-2007" in the vintage 2007 data) if you wish to request specific demographic and/or risk-factor information for a specific State or MSA. This rule also affects data requests when the U.S. is selected and the results are "grouped by" State or MSA, because a row for each location is shown. When the data are exported to a file, MSA has two columns, one for location name and a second column for code value. To see the list of MSA codes and labels for the previous OTIS vintages, request data grouped by MSA and export the results. OTIS includes data for MSAs with populations greater than 500,000 persons in the most recent data year. OTIS 2006 and later releases also reflect a change to the standard MSA codes and labels. Consequently, the metropolitan locations included in the data changed, some areas combined with larger areas, some areas are new, and some areas are omitted. This change is represented in the table below. MSAs with 500,000 or more population Current Code  Prior Code MSA Name 10420 0080 Akron, Ohio 10580 0160 Albany-Schenectady-Troy, NY 10740 0200 Albuquerque, NM 10900 0240 Allentown-Bethlehem-Easton, PA-NJ * 0440 Ann Arbor, Michigan 12060 0520 Atlanta-Sandy Springs-Marietta, GA 12260 * Augusta-Richmond County, GA-SC 12420 0640 Austin-Round Rock, TX 12540 0680 Bakersfield, CA 12580 0720 Baltimore-Towson, MD 12940 0760 Baton Rouge, LA * 0875 Bergen-Passaic, NJ 13820 1000 Birmingham-Hoover, AL 14260 * Boise City-Nampa, ID 14460 1123 Boston-Cambridge-Quincy, MA-NH 14860 * Bridgeport-Stamford-Norwalk, CT 15380 1280 Buffalo-Niagara Falls, NY 15980 2700 Cape Coral-Fort Myers, FL 16700 1440 Charleston-North Charleston, SC 16740 1520 Charlotte-Gastonia-Concord, NC-SC 16860 * Chattanooga, TN ** 16980 1600 Chicago-Naperville-Joliet, IL 17140 1640 Cincinnati-Middleton, OH-KY-IN 17460 1680 Cleveland-Elyria-Mentor, OH 17820 1720 Colorado Springs, CO 17900 1760 Columbia, SC 18140 1840 Columbus, Ohio 19100 1920, 2800, *  Dallas-Fort Worth-Arlington, TX 19380 2000 Dayton, Ohio * 2020 Daytona Beach, FL 19660 * Deltona-Daytona Beach-Ormond Beach, FL ** 19740 2080 Denver-Aurora, CO 19780 * Des Moines-West Des Moines, IA 19820 2160 Detroit-Warren-Livonia, MI 21340 2320 El Paso, Tex * 2760 Fort Wayne, Ind 23420 2840 Fresno, Calif * 2960 Gary, Ind 24340 3000 Grand Rapids-Wyoming, MI 24660 3120 Greensboro-High Point, NC 24860 3160 Greenville, SC 25420 3240 Harrisburg-Carlisle, PA 25540 3283 Hartford-West Hartford-East Hartford, CT 26180 3320 Honolulu, Hawaii 26420 3360 Houston-Sugar Land-Baytown, TX 26900 3480 Indianapolis-Carmel, IN 27140 * Jackson, MS 27260 3600 Jacksonville, FL * 3640 Jersey City, NJ 28140 3760 Kansas City, MO-KS 28940 3840 Knoxville, TN 29460 3980 Lakeland, FL 29820 4120 Las Vegas-Paradise, NV * 4280 Lexington, KY 30780 4400 Little Rock-North Little Rock, AR 31100 4480 Los Angeles-Long Beach-Santa Ana, CA 31140 4520 Louisville-Jefferson County, KY-IN 31540 * Madison, WI 32580 4880 McAllen-Edinburg-Mission, TX 32820 4920 Memphis, TN-MS-AR 33100 5000, 2680, *  Miami-Fort Lauderdale-Miami Beach, FL * 5015 Middlesex, NJ 33340 5080 Milwaukee-Waukesha-West Allis, WI 33460 5120 Minneapolis-St. Paul-Bloomington, MN-WI * 5160 Mobile, AL 33700 * Modesto, CA * 5190 Monmouth-Ocean City, NJ 34980 5360 Nashville-Davidson-Murfreesboro, TN * 5380 Nassau-Suffolk, NY 35300 5483 New Haven-Milford, CT 35380 5560 New Orleans-Metairie-Kenner, LA 35620 5600 New York-Northern New Jersey-Long Island, NY-NJ-PA * 5640 Newark, NJ 36260 * Ogden-Clearfield, UT ** 36420 5880 Oklahoma City, OK 36540 5920 Omaha-Council Bluffs, NE-IA * 5945 Orange County, CA 36740 5960 Orlando-Kissimmee, FL 37100 *, *, 8735 Oxnard-Thousand Oaks-Ventura, CA 37340 *, 4900, * Palm Bay-Melbourne-Titusville, FL 37980 6160, *, 9160  Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 38060 6200 Phoenix-Mesa-Scottsdale, AZ 38300 6280 Pittsburgh, PA 38860 * Portland-South Portland-Biddeford, ME 38900 6440 Portland-Vancouver-Beaverton, OR-WA 39100 * Poughkeepsie-Newburgh-Middletown, NY 39300 6483 Providence-New Bedford-Fall River, RI-MA 39580 6640 Raleigh-Cary, NC (Raleigh-Durham, NC) 40060 6760 Richmond, VA 40140 6780 Riverside-San Bernardino-Ontario, CA 40380 6840 Rochester, NY 40900 6920 Sacramento-Arden Arcade-Roseville, CA 41180 7040 St. Louis, MO 41620 7160 Salt Lake City, UT 41700 7240 San Antonio, TX 41740 7320 San Diego-Carlsbad-San Marcos, CA 41860 7360, 5775, *   San Francisco-Oakland-Fremont, CA 41940 7400 San Jose-Sunnyvale-Santa Clara, CA 41980 7440 San Juan-Caguas-Guaynabo, PR 42260 7510 Sarasota-Bradenton-Venice, FL 42540 7560 Scranton-Wilkes-Barre, PA 42660 7600, 8200, *  Seattle-Tacoma-Bellevue, WA 44140 8003 Springfield, MA 44700 8120 Stockton, CA 45060 8160 Syracuse, NY 45300 8280 Tampa-St. Petersburg-Clearwater, FL 45780 8400 Toledo, OH 46060 8520 Tucson, AZ 46140 8560 Tulsa, OK * 8720 Vallejo, CA 47260 *, 5720, *  Virginia Beach-Norfolk-Newport News, VA-NC 47900 8840 Washington-Arlington-Alexandria, DC-VA-MD-WV * 8960 West Palm Beach, FL 48620 9040 Wichita, KS 49660 9320 Youngstown-Warren-Boardman, OH-PA 99999 * Other areas combined * Indicates code not included in the data. ** Data reporting for the named MSA location begins with year 2007. Year Select only "All Years," or select only the last 5 years ("2003-2007" in the vintage 2007 data) or pick any combination of individual years from 1993-2007. How?   See How do I select items from the list box?. Notes:    The year shown indicates the year when the case was verified and submitted to the CDC as part of the official case count. In order to protect personal privacy, demographic and risk-factor information is limited to the national level for individual years of data. Select either "All Years" or the last 5 years ("2003-2007" in the vintage 2007 data) if you wish to request specific demographic and/or risk-factor information for a specific State or MSA. This rule also affects data requests when the U.S. is selected and the results are "grouped by" State or MSA, because a row for each location is shown. The value for the last 5 years combined is displayed and exported as code value: Code Value Data Set "2003-2007" vintage 2007 "2002-2006" vintage 2006 "2001-2005" vintage 2005 "2000-2004" vintage 2004 "1999-2003" vintage 2003 Step 3. Select demographics: Limit your data for any of the following data elements: Age Groups - 2 sets of age groups are available, Broad and Standard Sex - All, Female, Male, Not Reported Race / Ethnicity - Hispanic or Latino, Non-Hispanic (NH) racial categories for American Native, Asian / Pacific Islander, Black, White, Not Reported. Occupation - Correctional, Health care, Migratory Agricultural, Multiple, Not Employed, Other, Not Reported. How?   See How do I select items from the list box? and also see How do I change a "CheckBox?" A "Radio Button?" to pick your preferred list. Notes on Demographic Limits:    In order to protect personal privacy, demographic and risk-factor information is limited to the national level for individual years of data. If you wish to limit or "group by" (stratify) specific demographic and/or risk-factor information for a specific state or metropolitan area (MSA), then you must select either "All Years" or the last 5 years ("2003-2007" in the vintage 2007 data) as the requested time period. This rule also affects data requests when the U.S. is selected and the results are "grouped by" State or MSA, because a row for each location is shown. Age Groups Select either Broad or Standard age groups, and then pick any combination of age groups from one list. How?   See How do I select items from the list box? and also see How do I change a "CheckBox?" A "Radio Button?" to pick your preferred list. Notes:   The Age shown is the age group of the patient at the time of the first case report. Age groups are based on the patient's age in the month and year the patient was reported to the health department as a suspected case. See Demographic Limits above for more information about how other requested criteria affects the ability to show specific demographic data values. Broad Age Groups Select either Broad or Standard age groups, and then pick any combination of age groups from one list. How?   See How do I select items from the list box? and also see How do I change a "CheckBox?" A "Radio Button?" to pick your preferred list. Notes:   The Age shown is the age group of the patient at the time of the first case report. Age groups are based on the patient's age in the month and year the patient was reported to the health department as a suspected case. See Demographic Limits above for more information about how other requested criteria affects the ability to show specific demographic data values. The table below shows the Broad Age Groups, with each value's display-label and code-value as specified for data export. Display-Label Code-Value 0-4 years 0-4 5-14 years 5-14 15-24 years 15-24 25-44 years 25-44 45-64 years 45-64 65+ years 65+ Not Reported NR Standard Age Groups Select either Broad or Standard age groups, and then pick any combination of age groups from one list. How?   See How do I select items from the list box? and also see How do I change a "CheckBox?" A "Radio Button?" to pick your preferred list. Notes:   The Age shown is the age group of the patient at the time of the first case report. Age groups are based on the patient's age in the month and year the patient was reported to the health department as a suspected case. See Demographic Limits above for more information about how other requested criteria affects the ability to show specific demographic data values. The table below shows the Standard Age Groups, with each value's display-label and code-value as specified for data export. Display-Label Code-Value  < 1 year 1 1-4 years 1-4 5-14 years 5-14 15-24 years 15-24 25-34 years 25-34 45-54 years 45-54 55-64 years 55-64 65-74 years 65-74 75-84 years 75-84 85+ years 85+ Not Reported NR Sex The Sex variable shows the reported biological sex of the person. Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   See Demographic Limits above for more information about how other requested criteria affects the ability to show specific demographic data values. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value Female F Male M Not Reported NR Race / Ethnicity Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   The abbreviation "NH" stands for "Non-Hispanic," as shown in the Race /Ethnicity labels. See Demographic Limits above for more information about how other requested criteria affects the ability to show specific demographic data values. Race / Ethnicty values are calculated by combining race and ethnic origin variables into categories to determine the patients self-identified racial and ethnic category. Persons of Hispanic origin can be of any race. All other categories are non-Hispanic, single race. In 2003 and 2004, the Asian or Pacific Islander category contains cases among persons who self-reported race as Asian only or Native Hawaiian or other Pacific Islander only. TB cases of multiple race consist of less than 1% of all cases, and for 2003 and 2004 are categorized as Not Reported. The table below shows each Race / Ethnicity value's display-label and code-value as specified for data export. The code values are compliant with Public Health Information Network (PHIN) standards when applicable. Display-Label Code-Value American Indian or Alaska Native, NH 1002-5 Asian or Pacific Islander, NH A-PI * Black or African American, NH 2054-5 Hispanic or Latino 2135-2 White, Non-Hispanic (NH] 2106-3 Not Reported NR  *  Before the December 2008 release of OTIS Vintage 2007 data, the "Asian or Pacific Islander" code value was "2000-4" from the PHIN CDC Race Ethnicity code set. However, the "2000-4" value and the "Asian or Pacific Islander" race category are no longer supported in the current release of the CDC Race Ethnicity code set. Occupation Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates the occupation of the patient within the 24 months prior to diagnosis. See Demographic Limits above for more information about how other requested criteria affects the ability to show specific demographic data values. The table below shows each Occupation value's display-label and code-value as specified for data export. Display-Label Code-Value Health Care 1 Correctional 2 Migratory Agricultural 3 Multiple 4 Not Employed 5 Not Reported NR Step 4. Select Risk Factors: Limit your data for any of the following data elements: U.S. or Foreign Born - U.S. Born, Foreign Born, Not Reported Years in U.S. - Under 1 year, 1-4 years, 5-14 years, 15 or more years, Not Reported HIV Status - Postive, Negative, Not Reported Homeless in the Past Year? - Yes, No, Not Reported Residing in a Correctional Facility? - Yes, No, Not Reported Residing in a Long Term Care Facility? - Yes, No, Not Reported Place of Residence at Diagnosis? - Correctional Facility, Long Term Care Facility, Other, Not Reported Alcohol Use - Yes, No, Not Reported Drug Use, Injecting - Yes, No, Not Reported Drug Use, Non-injecting - Yes, No, Not Reported How?   See How do I select items from the list box? and also see How do I change a "CheckBox?" A "Radio Button?" to pick your preferred list. Notes on Risk Factor Limits:    In order to protect personal privacy, demographic and risk-factor information is limited to the national level for individual years of data. If you wish to limit or "group by" (stratify) specific demographic and/or risk-factor information for a specific state or metropolitan area (MSA), then you must select either "All Years" or the last 5 years ("2003-2007" in the vintage 2007 data) as the requested time period. This rule also affects data requests when the U.S. is selected and the results are "grouped by" State or MSA, because a row for each location is shown. U.S. or Foreign Born Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   See Risk Factor Limits above for more information about how other requested criteria affects the ability to show specific risk factor data values. "U.S. or Foreign Born" indicates if the patient is foreign-born, or born within the U.S. Foreign-born refers to persons born outside the United States and its possessions and dependencies. Exceptions include persons born overseas to U.S. citizens, such as patients born on military bases. The table below shows each "U.S. or Foreign Born" value's display-label and code-value as specified for data export. Display-Label Code-Value US - Born 1 Foreign - Born 2 Not Reported NR Years in U.S. Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   For foreign-born cases only, this variable shows the number of years since arrival in the U.S. Patients born in the U.S. are not applicable for inclusion in this data element. Thus, the data results may show "Not Applicable" values when the request criteria includes data for patients born in the United States. Totals and percentages shown for this data element do not include patients born in the United States, and thus may differ when compared to other data elements where U.S. born cases are included. The table below shows each "Years in U.S." value's display-label and code-value as specified for data export. Display-Label Code-Value < 1 year 1 1-4 years 1-4 5-14 years 5-14 15+ years 15+ Not Reported NR HIV Status Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   See Risk Factor Limits above for more information about how other requested criteria affects the ability to show specific risk factor data values. The patient's HIV status is based on published definitions. (Centers for Disease Control and Prevention. Interpretation and use of the Western Blot Assay for serodiagnosis of human immunodeficiency virus type 1 infections. MMWR 1989;38 (No. S-7): 1-7.) Status is considered positive if the patient is tested for HIV and the lab result is interpreted as positive based on published criteria, if the patient has a documented history of previous positive HIV test or diagnosis of HIV infection, or this patient gives a history of a previous positive HIV test. "Not Reported" status includes indeterminate; refused test; test not offered; test done, results unknown; and missing values. The information on HIV status for TB cases is incomplete and data should be interpreted with caution. There are a number of reasons for incomplete reporting of HIV test results to the national TB surveillance system including: concerns about confidentiality of data, which may limit the exchange of data between TB and HIV/AIDS programs; laws and regulations in certain states and local jurisdictions that have been interpreted as prohibiting the HIV/AIDS program from sharing the HIV status of TB patients or from reporting patients with TB and AIDS to the TB program; the voluntary nature of HIV testing, which some TB patients may decline or for those that are tested, may not choose to share the results with their health department; and reluctance by health care providers to report HIV test results to the TB surveillance program staff. As a result these data may not be representative of all TB patients with HIV infection. When analyzing HIV status of TB cases, keep in mind the following limitations: California does not report HIV test results to CDC for TB cases. In place of HIV reporting, California reports TB cases which have a co-diagnosis of AIDS, as determined by the presence of an AIDS case report in the state AIDS registry. California performs a TB-AIDS case match on an annual basis after both registries have finalized their case counts for the previous year, and sends the data to CDC. Thus, California is one year behind the current reporting year in reporting HIV data to the national TB surveillance system. California cases listed as HIV-positive in the national TB surveillance system for this time frame include TB cases with a co-diagnosis of AIDS. All other California TB cases have an unknown HIV status. The HIV variable, in general, has a high percentage of missing or unknown data. For example, from 1998 through 2000, national HIV results including California showed over 52% missing or unknown. Excluding California, over 42% were missing or unknown during this time. All HIV data from the state of Louisiana is suppressed when shown at the state or metropolitan (MSA) level. HIV data for Louisiana is included at the national level. The table below shows each "HIV Status" value's display-label and code-value as specified for data export. Display-Label Code-Value Negative N Positive P Not Reported NR Homeless in the Past Year? Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   "Homelessness Status" value indicates whether the patient was homeless at any time within the 12 months prior to diagnosis. See Risk Factor Limits above for more information about how other requested criteria affects the ability to show specific risk factor data values. The table below shows each "Homelessness Status" value's display-label and code-value as specified for data export. Display-Label Code-Value No N Yes Y Not Reported NR Residing in a Correctional Facility? Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates whether the patient an inmate of a correctional facility at the time the TB diagnostic evaluation was performed. See Risk Factor Limits above for more information about how other requested criteria affects the ability to show specific risk factor data values. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value No N Yes Y Not Reported NR Residing in a Long-Term Care Facility? Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates whether the patient was a resident of a long-term care facility at the time the TB diagnostic evaluation was performed. See Risk Factor Limits above for more information about how other requested criteria affects the ability to show specific risk factor data values. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value No N Yes Y Not Reported NR Place of Residence at Diagnosis? Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates the patient's place of residence at the time the TB diagnostic evaluation was performed. See Risk Factor Limits above for more information about how other requested criteria affects the ability to show specific risk factor data values. The table below shows each "Residence at Diagnosis" value's display-label and code-value as specified for data export. Display-Label Code-Value Correctional Facility 1 Long-term Care Facility 2 Other 3 Not Reported NR Alcohol Use Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates whether the patient used alcohol to excess within the 12 months prior to diagnosis. See Risk Factor Limits above for more information about how other requested criteria affects the ability to show specific risk factor data values. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value No N Yes Y Not Reported NR Drug Use, Injecting Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates whether the patient used an (illegal) injecting drug within the year prior to diagnosis. Injecting drug use involves use of hypodermic needles and syringes for injection of drugs not prescribed by a physician. See Risk Factor Limits above for more information about how other requested criteria affects the ability to show specific risk factor data values. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value No N Yes Y Not Reported NR Drug Use, Non-injecting Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates whether the patient used a non-injecting (illegal) drug within the year prior to diagnosis. Non-injecting drug use involves the use of licensed or prescription drugs or illegal drugs that were not injected and were not prescribed by physician. See Risk Factor Limits above for more information about how other requested criteria affects the ability to show specific risk factor data values. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value No N Yes Y Not Reported NR Step 5. Select Disease Criteria: Limit your data for any of the following data elements: Disease Site - Pulmonary, Extrapulmonary, Both, Not Reported Multidrug-Resistant - Yes, No, Not Reported Previous TB - Yes, No, Not Reported Verification Criteria - Positive Culture, Positive Smear or Tissue, meets Clinical Case Definition, Provider Diagnosis How?   See How do I select items from the list box?. Receives Directly Observed Therapy? Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates whether patient received self-administered or directly observed therapy, as defined as the direct visual observation by a health care provider or other reliable party of the patient's ingestion of medication. (American Thoracic Society. Control of Tuberculosis in the United States. Am Rev Respir Dis 1992;146:1623-1633.) Due to reporting treatment-related delays, only data for years 1993 through 2005 are available in Vintage 2007 [data for years 1993-2004 are available in Vintage 2006, for years 1993-2003 in Vintage 2005, for years 1993-2002 in Vintage 2004, and for years 1993-2001 in Vintage 2003). The Directly-observed therapy (DOT) status of a patient is reported on the RVCT follow-up report. DOT or supervised therapy involves the direct visual observation by a health care provider or other reliable person of a patient's ingestion of medication. DOT regimens may be administered daily, three times a week, or twice weekly. DOT is currently recommended as the best practice treatment for TB patients by the Centers for Disease Control and Prevention. Directly Observed Therapy data are reported from the years 1993 through 2005 in Vintage 2007 [through 2004 in Vintage 2006, through 2003 in Vintage 2005, through 2002 in Vintage 2004, and through 2001 in vintage 2003). Because states have up to two years to report these types of data, the evidence lags 2 years behind the current report year. The criteria for inclusion in the DOT data element are: The patient is alive in the specific year; the case record's "Vital Status" value is "alive." Patients that have died in the specified year are not applicable for inclusion in this data element. The patient is receiving treatment with one or more anti-TB drugs. Cases that do not report an active treatment regimen are not included in the DOT measure. Data for any year through 2004 ( through 2003 in Vintage 2005, through 2002 in Vintage 2004, through 2001 in Vintage 2003). Case reports for years after the 2 year time period preceding the final reporting year are not available for inclusion in this data element. Thus, the data results may show "Not Applicable" values when the request criteria includes data for patients that died in the specified year, or case reports that do not indicate treatment with one or more anti-TB drugs, or data for 2 years preceding the final reporting year . Totals and percentages shown for this data element do not include patients that died in the specified years, nor cases that do not indicate treatment with one or more anti-TB drugs, nor case reports for 2 years preceding the final reporting year. Thus totals and percentages may differ when compared to other data elements where those records are included. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value Self Only 1 Direct Only 2 Both 3 Not Reported NR Disease Site Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   About Miliary Disease Adjustment -- Miliary disease is classified as both an extrapulmonary (outside lungs) and a pulmonary (in lungs) form of TB. In publications prior to 1997, miliary disease was classified as extrapulmonary TB unless pulmonary disease was reported as the major site of TB disease. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value Pulmonary 1 Extrapulmonary 2 Both 3 Not Reported NR Multidrug-Resistant Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates if patient has an initial M. tuberculosis isolate resistant to at least Isoniazid (INH) and Rifampin (RIF). when the patient did not show resistance to both INH and RIF in initial susceptibility testing. The case verification criteria and drug susceptibility testing variables collected on the RVCT forms are used to calculate whether a patient has MDR-TB. Patients must have a positive culture and susceptibility testing completed in order to be part of the population (i.e., denominator) for the MDR-TB calculation. If the patient meets these two criteria and has susceptibility results that show resistance to at least the drugs isoniazid and rifampin, he/she is defined as having multidrug-resistant TB. This calculation does not consider resistance to other drugs. Resistance to either isoniazid (INH) or rifampin (RIF) and any other drug, is not defined as MDR-TB. when the patient did not show resistance to both INH and RIF in initial susceptibility testing. For inclusion in the MDR data element: The "Verification Criteria" value must be "Postive Culture." Those cases with other values for the "Verification Criteria" variable are not applicable for inclusion in MDR. The cases must also show initial susceptibility testing results for resistance to both INH and RIF, thus not all cases verified by a postive culture are included in MDR. The data results may show "Not Applicable" values when the request criteria includes data for patients with "Verification Criteria" values other than "Positive Culture," or when the patient did not show resistance to both INH and RIF in initial susceptibility testing. Totals and percentages shown for this data element do not include patients with "Verification Criteria" values other than "Positive Culture," nor case reports when the patient did not show resistance to both INH and RIF in initial susceptibility testing. Thus totals and percentages may differ when compared to other data elements where those records are included. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value No N Yes Y Not Reported NR Previous TB Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates if this patient has had a previous diagnosis of TB. Previous diagnosis is defined as having had verifiable disease in the past, been discharged (e.g., completed treatment) or lost to supervision for more than 12 consecutive months, and then had verifiable disease again. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value No N Yes Y Not Reported NR Verification Criteria Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   The Verification Criteria variable groups cases based on the criteria used to determine which part of the case definition was used to verify cases. Valid criteria for case report verification are: positive culture result for lab test; Positive smear/tissue result for lab test; case meets the criteria in the clinical case definition; and provider diagnosis. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value Positive Culture 1 Positive Smear/Tissue 2 Clinical Case Def 3 Provider Diagnosis 4 Step 6. Select Therapy Issues: Limit your data for any of the following data elements: Receives Directly Observed Therapy? - Directed therapy Only, Self-administered Only, Both, Not Reported Vital Status - Alive, Dead, Not Reported Completion of Therapy within 1 year - No, Yes, Not Applicable Tested for Isoniazid Susceptibility - Yes, No, Not Applicable Tested for Isoniazid & Rifampin Susceptibility - Yes, No, Not Applicable How?   See How do I select items from the list box?. Receives Directly Observed Therapy? Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Indicates whether patient received self-administered or directly observed therapy, as defined as the direct visual observation by a health care provider or other reliable party of the patient's ingestion of medication. (American Thoracic Society. Control of Tuberculosis in the United States. Am Rev Respir Dis 1992;146:1623-1633.) Due to reporting treatment-related delays, only data for 1993 - 2005 are available in Vintage 2007 ( for 1993-2004 in Vintage 2006, for 1993-2003 in Vintage 2005, for 1993-2002 in Vintage 2004, and for 1993-2001 in Vintage 2003). The Directly-observed therapy (DOT) status of a patient is reported on the RVCT follow-up report. DOT or supervised therapy involves the direct visual observation by a health care provider or other reliable person of a patient's ingestion of medication. DOT regimens may be administered daily, three times a week, or twice weekly. DOT is currently recommended as the best practice treatment for TB patients by the Centers for Disease Control and Prevention. Directly Observed Therapy data are reported from the year 1993 through 2005 in Vintage 2007 (through year 2004 in Vintage 2006, through 2003 in Vintage 2005, through 2002 in Vintage 2004, and through 2001 in vintage 2003). Because states have up to two years to report these types of data, the evidence lags 2 years behind the current report year. The criteria for inclusion in the DOT data element are: The patient is alive in the specific year; the case record's "Vital Status" value is "alive." Patients that have died in the specified year are not applicable for inclusion in this data element. The patient is receiving treatment with one or more anti-TB drugs. Cases that do not report an active treatment regimen are not included in the DOT measure. Data for any year through 2005 in Vintage 2007, (through 2004 in Vintage 2006, through 2003 in Vintage 2005, through 2002 in Vintage 2004, through 2001 in Vintage 2003). Case reports for years after the 2 year time period preceding the final reporting year are not available for inclusion in this data element. Thus, the data results may show "Not Applicable" values when the request criteria includes data for patients that died in the specified year, or case reports that do not indicate treatment with one or more anti-TB drugs, or data for 2 years preceding the final reporting year . Totals and percentages shown for this data element do not include patients that died in the specified years, nor cases that do not indicate treatment with one or more anti-TB drugs, nor case reports for 2 years preceding the final reporting year. Thus totals and percentages may differ when compared to other data elements where those records are included. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value Self Only 1 Direct Only 2 Both 3 Not Reported NR Vital Status Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes:   Vital Status indicates whether the patient was alive or dead at the time of diagnosis. Patient is considered dead at diagnosis if deceased at the time the investigation of possible TB was initiated. The table below shows each value's display-label and code-value as specified for data export. Display-Label Code-Value Alive 1 Dead 2 Not Reported NR Completion of Therapy (COT) in less than 366 days (one year) Completion of Therapy data are available both as a categorical variable (yes, no, not applicable) and as a percentage measure. Completion of Therapy (COT) indicates if the patient completed TB therapy in less than 366 days for patients with "uncomplicated" TB. Those TB cases that complete therapy within 366 days or less and have met several criteria (see detailed criteria in next paragraph) are categorized as "Yes." Those TB cases that did not complete therapy in 366 days or less, and also did not meet the criteria for exclusion are categorized as "No." Those TB cases that meet the criteria for exclusion are categorized as "Not Applicable." The criteria for exclusion includes cases reported two years or less before the final reporting year, cases where the patient is not alive, and "complicated" cases. In order to determine whether a case is "uncomplicated," TB cases are stratified by the indicated length of therapy, based on American Thoracic Society/CDC treatment guidelines 14,15 in effect during the period covered, and the patients initial drug susceptibility test results, age, and site of disease. The adequacy of the treatment regimen (e.g., the sufficiency of the duration of therapy, the appropriateness of the prescribed TB drugs) are not part of the calculation of COT. Acquired drug resistance during therapy with the need for a longer duration of therapy is also not considered. The determination of the indicated length of therapy for 366 days or less is based on a number of factors. Patients with an initial M. tuberculosis isolate resistant to rifampin, patients with meningeal disease, and pediatric patients (less than 15 years old) with miliary disease or positive blood culture require therapy for greater than 366 days and are therefore classified as "Not Applicable" for measuring Completion of Therapy in OTIS. For all other patients, including those with culture-negative disease, those with an unknown culture status, and those with culture-positive disease, but unknown initial drug susceptibility test results, data were included in the calculation of COT for those with 1 year or less of therapy indicated. Select "All" or any combination of values from the list. How?   See How do I select items from the list box?. Notes: The cases categorized as "Yes" meet the following criteria: patients had an indicated length of therapy of 1 year or less, patients were alive at diagnosis and prescribed an initial regimen of one or more drugs, and did not meet the criteria described below for the "Not Applicable" category. The cases categorized as "No" meet the following criteria: patients had an indicated length of therapy of more than 1 year, patients were alive at diagnosis and prescribed an initial regimen of one or more drugs, and did not meet the criteria described below for the "Not Applicable" category. "Not Applicable" is displayed for the Completion of Therapy (COT) value when the data includes: case reports with an initial M. tuberculosis isolate resistant to rifampin; patients with meningeal disease; pediatric patients (less than 15 years old) with miliary disease; pediatric patients (less than 15 years old) with a positive blood culture; patients that were not alive at diagnosis, and patients that died during therapy; case reports where the "Vital Status" value is "Dead." case reports within the 2 year period preceding the "Vintage" year of the data set, which is the final year included in the data set, also known as the current reporting year. The criteria for the COT calculation changed with OTIS Vintage 2006 and later: previous data releases included patients over age 15 with meningeal disease and pediatric patients with positive blood cultures, and excluded pediatric patients with bone or joint disease. For the calculation of the COT percentage measure: Cases that are categorized as "Yes" are included in the numerator. Cases that are categorized as either "Yes" or "No" are included in the denominator. Cases that are categorized as "Not Applicable" are excluded from the calculation. Due to treatment-related reporting delays, Completion of Therapy (COT) data and Directly Observed Therapy (DOT) data are reported from 1993 through two (2) years preceding the last year of data included in the dataset. States have up to two years to report these types of data, thus the case evidence lags 2 years behind the current report year. For example, the Vintage 2007 OTIS dataset reports Completion of Therapy for the years 1993-2005. OTIS Vintage 2005 and later years report Completion of Therapy (COT) data as a categorical variable and as a percentage measure. In the previous annual data sets, Completion of Therapy (COT) is displayed as a percentage measure only, and not as a categorical variable. Tested for Isoniazid Susceptibility Drug Susceptibility Testing for Isoniazid (INH) data are available both as a measure and as a Disease Critera variable. Cases with drug susceptibility testing for Isoniazid: All case reports are categorized to indicate whether drug susceptibility test results for Isoniazid (INH) are reported. The categories are Yes, No and Not Applicable. Select specific categories, or choose to group your data by this variable in the Request form. How?   See How do I select items from the list box?. Notes: The "Yes" category shows the number of culture-confirmed cases where drug susceptibility testing results are indicated in the case report (susceptible or resistant). The "No" category shows the number of culture-confirmed cases where drug susceptibility testing results are not included in the case report. The "Not Applicable" category shows the number of cases that are not culture-confirmed. Tested for Isoniazid & Rifampin Susceptibility Drug susceptibility testing for Isoniazid (INH) and Rifampin (RIF) data are available both as a measure and as a Disease Critera variable. Cases with drug susceptibility testing for Isoniazid and Rifampin: All case reports are categorized to indicate whether drug susceptibility test results for Isoniazid (INH) and Rifampin (RIF) are reported. The categories are Yes, No and Not Applicable. Select specific categories, or choose to group your data by this variable in the Request form. How?   See How do I select items from the list box?. Notes: The "Yes" category shows the number of culture-confirmed cases where drug susceptibility testing results are indicated in the case report (susceptible or resistant). The "No" category shows the number of culture-confirmed cases where drug susceptibility testing results are not included in the case report. The "Not Applicable" category shows the number of cases that are not culture confirmed. Step 7. Other options: Export Results   If checked, then query results are exported to a local file. More information on how to import this file into other applications can be found here. How?   See CheckBox. Show Totals   If checked, then totals and sub-totals display in the results table. How?   See CheckBox. Show Zero Values   If checked, then rows containing zero counts display in the results table. If unchecked, then zero count rows are suppressed. How?   See CheckBox. Precision   Choose the precision for the rates calculated with your data. Select the number of digits shown after the decimal point. Data Access Timeout   This value specifies the maximum time to wait for the data access for a query to complete. If the data access takes too long to complete, a message will be displayed and you can increase the timeout or simplify your request. If you can't complete a request using the maximum timeout, contact user support and we will try to run a custom data request for you. Data Source Information To learn more about the methods and source of these data please refer to: OTIS Technical Reference OTIS Assurance of Confidentiality TB Case Definition: see Appendix B for the desired annual report at http://www.cdc.gov/tb/surv/ TB Case Count: see Appendix C for the desired annual report at http://www.cdc.gov/tb/surv/ OTIS variables definition from the RVCT Form Instructions Tuberculosis Information Management System (TIMS) and User's Guide Glossary of TB Terms Annual TB Surveillance Reports Additional Information Suggested Data Source Citations Incidence Data Online Tuberculosis Information System (OTIS), National Tuberculosis Surveillance System, United States, 1993-2007. U.S. Department of Health and Human Services (US DHHS), Centers for Disease Control and Prevention (CDC), CDC WONDER On-line Database, January 2009. Note:  Citations for archive data vary as listed: Data Set     Data Years     Database Released Vintage 2006     1993-2006     February 2008 Vintage 2005     1993-2005     September 2007 Vintage 2004     1993-2004     March 2006 Vintage 2003     1993-2003     May 2005 Population Sources Population denominators used to calculate United States national and state rates for the years 1993-2007 were obtained from the National Center for Health Statistics bridged-race population counts. Two series were combined: The postcensal resident population July 1st estimates, based on the Census 2000 counts: TB Data Set     Population Estimates Series     Series Released Vintage 2007     2001 - 2007     September 5, 2008 Vintage 2006     2001 - 2006     August 16, 2007 Vintage 2005     2001 - 2005     August 16, 2006 Vintage 2004     2001 - 2004     September 8, 2005 Vintage 2003     2001 - 2003     September 14, 2004 The intracensal July 1st population estimates for 1990-1999 (release date July 26, 2004). The 1990-1999 estimates were updated to incorporate the bridged-single-race estimates of the April 1, 2000 resident population. The files were prepared under a collaborative arrangement with the U.S. Census Bureau, with support from the National Cancer Institute. See National Center for Health Statistics Population Estimates for more information. Population denominators used to calculate rates for Puerto Rico were obtained from the following sources: Puerto Rico July 1st resident population estimates for years 2006 and 2007 in OTIS Vintage 2007 were obtained from the Annual Estimates of the Population for the United States and States, and for Puerto Rico:   April 1, 2000 - July 1, 2007 (NST-EST2006-01) accessed June 25, 2008 at http://www.census.gov/popest/states/tables/NST-EST2007-01.xls. Puerto Rico July 1st resident population estimates for years 1993-2005 were obtained from the U.S. Census Bureau, International Data Base, accessed at http://www.census.gov/ipc/www/idb/country/rqportal.html#DI, table 1. Estimates for years 1993-2005 in OTIS Vintage 2005 were accessed on September 6, 2007. Rates for Puerto Rico are available only in OTIS Vintage 2005 and later. Contact For questions about the National Tuberculosis Surveillance System, please contact the program at E-mail: tbinfo@cdc.gov Phone: (404) 639-8135 Note:   State and local health departments have the most up-to-date and complete data making them the best source for local inquiries; therefore for further state-specific information, please contact the health department of the particular state. Data Release Policies Data release policies imposed to protect personal privacy, and to honor the policies of our partners: Values less than 5: All cell values representing less than 5 cases are suppressed at the metropolitan (MSA) level. Cell values representing less than 5 cases are suppressed at the state level, unless the cell displays the total cases reported by a state for a period of one or more years. Note that for data released prior to October 31, 2007, for OTIS data vintages 2004 and 2003, values representing cases counts less than or equal to 3 are suppressed for state data unless the total cases in 1 year are shown, and values less than 4 are suppressed for all metropolitan data. Louisiana HIV data: All HIV data from the state of Louisiana is suppressed when shown at the state or metropolitan (MSA) level. HIV data for Louisiana is included at the national level. Case counts: Case counts are not shown for state-level data in OTIS 2005, unless 5 or more years of data are combined. Rates: Incidence rates are calculated only for national or state data in OTIS 2005, and incidence rates are calculated only for national data in the preceding data vintages 2003 and 2004. Note: Errata for the Completion of Therapy calculation for data vintages 2003 and 2004: On August 29, 2007, the formula for the calculation of Completion of Therapy was revised. The algorithm now includes case reports for patients that are 14 years of age in the subset of cases that are measured. Slight discrepancies were noted when comparing the Completion of Therapy measures generated by OTIS vintage 2003 and vintage 2004 to the previously published TB Surveillance Annual Summary reports for the same year. This discrepancy was identified as the omission of the case reports for 14 year old patients. We apologize for this error.

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This page last reviewed: Friday, January 09, 2009

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